Medical Certificates from medicalcert.co.uk

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Nameas it should appear on the certificate

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Date of Birth

Date

3

Sex

Female

Male

Prefer not to say

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Emailwhere the certificate will be delivered

5

Phone

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What is the main reason for medical letter?

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Start date of your symptoms

Date

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Condition status

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.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

10

Have you consulted a Medical Cert doctor 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.

12

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

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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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Name of your Educational Institution

17

Desired certificate start dateWe can back-date certificates with evidence but cannot forward-date.

Date

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Desired certificate end date (inclusive)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.

Date

19

Are you pregnant or breastfeeding?

Yes

No

20

Please provide details regarding your pregnancy

21

Have you sought medical care from your GP or local A&E for your medical issue before?

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?

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

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Select files to upload

Max. file size: 10.6MB

24

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

25

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 condition, 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.

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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.

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Select files to upload

Max. file size: 10.6MB

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Please attach a form of 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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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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Study Sick Leave

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My Products* This field is required.

My Bag

1

Study Sick Leave assessmentIf we are unable to issue your certificate for any reason you will receive a full refund.
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