Employee Fitness to Work Medical Questionnaire

Do you have any pre-existing health conditions your Partner Practitioner should be aware of? *

Yes No

Are you taking any medications regularly? *

Yes No

How far can you walk before you have to stop to catch your breath? *

Few hundred yards Limited to 1 mile Unlimited

STANDARD REQUEST

This will be reviewed, signed by a UK health practitioner and sent via email.

£39.00

RECOMMENDED EXPRESS REQUEST

This will be reviewed, signed by a UK health Practitioner, and sent via email. Typically, you can expect to receive it within the same day.

£55.00

Please double check your details below. These will appear on the medical letter, if suitable, and can't be edited after submission.

Name:

Date of birth:

Sex:

Male

Email:

Mobile:

Letter type:

Employee Fitness to Work Medical

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, unable to swallow fluids or saliva, weakness or numbness down one side, slurred speech.
You have comprehended the questions in the questionnaire and answered them honestly.
The requested letter is solely for the individual with the provided name and details.
The GP Clinic is not a replacement for a doctor's visit, nor is The GP Clinic your primary doctor or GP, and your Partner Practitioner may be unable to access your NHS or regular GP medical records.
The GP Clinic facilitates access to private medical letters and does not issue Med3 notes, which are obtainable through your NHS GP for UK government benefits.
The GP Clinic cannot complete additional forms requested by your workplace, educational institution, or any other interested party.
If your symptoms persist or you have not fully recovered, you agree to consult with your regular doctor or GP for further medical advice.
The GP Clinic is unable to process refunds once our GP has reviewed your request and you've been sent a letter written by them. No exceptions.

Agree

The GP Clinic