Medical Certificates from medicalcert.co.uk

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Full Nameas it should appear on the certificate

First Name

Last Name

2

Date of Birth

Date

3

Sex

Female

Male

Prefer not to say

4

Emailwhere the certificate will be delivered

5

PhoneIf the doctor requires further information they may contact you on your phone.

6

Please explain why you need a housing support letter

Minimum 10 words

0/0

7

What medical condition(s) do you suffer from? You will be given the opportunity to attach any relevant medical letters and evidence later

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What symptoms do you experience?

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In what way is your current housing impacting your health condition?

10

What changes do you require to your housing?

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How would these changes improve your health condition?

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Do you take any regular medications?(Whether prescribed or purchased over the counter)

YESNO

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Please list any regular medication you take, whether prescribed or over-the-counter:

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How many flights of stairs are you able to climb before you have to stop to catch your breath?

0

1-2

3

4+

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Medical Evidence

In order to issue your certificate, in the next pages you will be asked to provide:

Evidence of your condition: This can be copies of medical communication, test results, screenshots of your diagnosis from your NHS app, or a copy of your summary care record (health record) available free from your GP.
A photo of your ID or Passport
A selfie (photo of yourself) for ID verification

Note: If you do not have your documents to hand, you can click the save icon below to save and return to this form later. Your data and ID is used solely for this consultation and never shared.

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Please upload Medical EvidenceEg. copies of medical communication, test results, screenshots of your diagnosis from your NHS app, or a copy of your summary care record (health record) from your GP.

Drag and drop files here

Select files to upload

Max. file size: 20.4MB

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Please attach a form of ID as proof of identification.Accepted forms of ID include: photo of your driver's license, passport, work badge, residence permit, or military ID card.

Drag and drop files here

Select files to upload

Max. file size: 20.4MB

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Terms

I agree that upon submitting my medical consultation, I acknowledge the Terms and Privacy Policy and consent to the following: I am NOT seriously unwell with any of the following symptoms: chest pain, shortness of breath, unrelenting severe headache, worsening severe abdominal pain, loss of vision, thoughts of suicide, confusion, ongoing bleeding, unable to swallow fluids or saliva, loss of limb sensation or control, facial numbness or weakness, slurred speech. I understand the questions in the questionnaire and answered them honestly. The requested letter is solely for the individual with the provided name and details. Medical Cert is not a replacement for a doctor's visit. I confirm I do not think I need to see a medical professional in person. Medical Cert is not my primary doctor or GP, and the doctor issuing my certificate may be unable to access my NHS or regular GP medical records. Medical Cert facilitates access to private medical letters and does not issue Med3 notes, which are obtainable through your NHS GP for UK government benefits. Medical Cert is unable to process refunds once a medical letter has been written and sent to you. If my symptoms persist or I have not fully recovered, I agree to consult with my regular doctor or GP for further medical advice. I consent to having this website store my submitted information so they can respond to my inquiry.

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Housing Support Letter

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My Products* This field is required.

My Bag

1

Consultation for Housing Support Letter
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