Medical Certificates from medicalcert.co.uk

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Name* This field is required.as it should appear on the certificate

First Name

Last Name

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Sex* This field is required.

Female

Male

Prefer not to say

3

Email* This field is required.where the certificate will be delivered

4

Phone* This field is required.

5

What is the main reason for medical letter?

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Date of Birth* This field is required.

Date

8

Start date of your symptoms* This field is required.

Date

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Condition status* This field is required.

Ongoing

Partially Recovered

Recovered

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Please describe all your symptoms and timeline in detail. Please provide as much information and detail as possible.* This field is required.More detail will help our doctors issue your letter quickly. Insufficient detail may delay your letter, as our doctors may have to contact you for further clarification before issuing a letter.

20 words minimum.

0/0

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Have you received a certificate from us regarding the same condition before?

YESNO

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Have any treatments or investigations taken place since your last submission?* This field is required.Please provide an update on your condition if anything has changed.

13

In the past month, have you had thoughts about suicide?* This field is required.

YESNO

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Have you ever made a suicide attempt?* This field is required.

YESNO

15

Are you having thoughts of suicide right now?* This field is required.

YESNO

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Please access urgent help via one of the 24hr services below:* This field is required.Samaritans – for everyone Call 116 123 Email jo@samaritans.org Campaign Against Living Miserably (CALM) Call 0800 58 58 58 – 5pm to midnight every day Visit the webchat page Papyrus – prevention of young suicide HOPELINE247 Call 0800 068 41 41 Text 07860 039967 Email pat@papyrus-uk.org or you can call 111 and they will help you find the support and help you need

I agree to contact a mental health service today

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Your Workplace / Company name / Institution* This field is required.

18

Please describe your daily work activities

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Desired certificate start date* This field is required.We can back-date certificates with evidence but cannot forward-date.

Date

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Desired certificate end date (inclusive)* This field is required.After reviewing your medical evidence, our doctors can provide up to 14 days of sickness leave with your certificate, but may recommend a different dates based on their professional judgment. If you are still unwell after the initial period, you may apply for a further sickness certificate for additional leave.

Maximum 14 days from desired certificate start date

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Are you pregnant or breastfeeding?* This field is required.

Yes

No

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Please provide details regarding your pregnancy

23

Have you sought medical care from your GP or local A&E for your medical issue before?* This field is required.

Yes, from my GP

Yes, I visited A&E

No, never consulted a doctor for this before

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What treatment was administered in A&E or by your GP?* This field is required.

25

Please upload photos of your A&E discharge summary, if available

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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Please list any underlying health issues or past medical history:If none, please write None

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Please list any regular medication you take, whether prescribed or over-the-counter:If none, please write None

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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 a short video of you simply describing your symptoms, a photo of your injury/problem, copies of medical communication, prescriptions, test results, screenshots from your NHS app, etc.
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 any Medical Evidence* This field is required.E.g. photo/video of your condition, copies of medical communication, prescriptions, test results, screenshots from your NHS app.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Our doctors can only begin working on the certificate if this is received,

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Please attach a photo of your ID as proof of identification.* This field is required.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: 10.6MB

We respect your data privacy and all personal information is processed confidentially and never shared.

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Take a Selfie * This field is required.Please take a clear photo of yourself for identity verification purposes.

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Terms* This field is required.

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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PaymentPlease do not close or refresh the page until payment completion.

My Bag

1

Sickness ConsultationIf we are unable to issue a certificate for you for any reason, you will automatically receive a full refund.
£47.00Edit
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First Name

Last Name