Certificate of Good Health &#8211; Medical Certificates

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Full Name* This field is required.

First Name

Last Name

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Date of Birth* This field is required.

Date

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Phone Number* This field is required.

Country Code

Phone Number

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Sex* This field is required.

Female

Male

Prefer not to say

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Email (where the electronic certificate will be delivered):* This field is required.

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Country for which this certificate will be used for* This field is required.

Please note some countries may require chest x-rays and blood work in addition to the certificate of good health.

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Type of Visa Applied for (eg. Work, Study, Tourist)* This field is required.

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If your visa is for work, what work will you be doing?* This field is required.

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Address

Street Address

City

County / Province

Postal / Zip Code

Country

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NHS Number

Leave blank if you do not have an NHS number.

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NHS SugeryPlease provide the name of your NHS surgery if you are registered with an NHS GP.

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Do you have any medical conditions or past medical history?* This field is required.

YESNO

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Please detail any existing diseases or health conditions that you currently have. Please provide a timeline.* This field is required.

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Do you take any medication?* This field is required.Prescribed or purchased over the counter

YESNO

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Please list any medication you take including dose and frequency* This field is required.

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Do you suffer from any infectious or contagious diseases? * This field is required.

YESNO

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Please provide details

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Are you presently sick due to any infections? * This field is required.

YESNO

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Please provide details

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Have you ever had any infectious diseases in the past that required isolation?* This field is required.

YESNO

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Please provide details

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Have you previously been diagnosed with Tuberculosis (TB)?* This field is required.

YESNO

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Please provide details

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Have you previously been diagnosed with HIV/AIDS?* This field is required.

YESNO

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Please provide details

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Have you recently been exposed to any individuals with contagious diseases?* This field is required.

YESNO

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Please provide details

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Have you received all the vaccinations required by the destination country?* This field is required.

YESNO

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Is there any other relevant medical information or specific requirements related to your visa application that you would like to share with the GP for the Visa Medical Certificate or Certificate of Good Health?

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Please upload your GP Summary Care Record or documentation of your medical historyScreenshots of your health history from your NHS app are also acceptable.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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Please attach a photo of your Passport

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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Take a SelfiePlease take a clear photo of your face for identity verification

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Terms* This field is required.Upon submitting your medical consultation, you acknowledge our Terms and Privacy Policy and consent to the following: - You are 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. - You 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. You confirm you do not think you need to see a medical professional. - Medical Cert is not your primary doctor or GP, and the doctor issuing your certificate may be unable to access your 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 your symptoms persist or you have not fully recovered, you agree to consult with your 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.

I agree

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I understand Medical Cert cannot advise on which visas can accept e-certificates and that it is my responsibility to ensure that I have checked the requirements for my visa* This field is required.Medical Cert cannot send hard-copies with wet-ink signatures, you will receive a digital Certificate of Good Health as per IHR 2005.

I agree

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Visa Medical

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Payments

My Bag

1

Certificate of Good Health consultationIf we are unable to issue your certificate for any reason you will receive a full refund.
£59.00Edit
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First Name

Last Name

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