Gym and Health Club Cancellation Certificate Questionnaire

Health and Fitness Information

Do you have any pre-existing medical conditions that affect your ability to use the gym or health club facilities? *

Yes No

Have you experienced any injuries or health issues related to your gym or health club activities? *

Yes No

Are you currently under medical treatment or taking any medications that affect your ability to use the gym or health club facilities? *

Yes No

Priority options: *

STANDARD REQUEST

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

£45.00

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

Confirm your details

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:

Gym and Health Club Cancellation Certificate

Terms

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.
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.

Do you agree to the above Terms? *

Agree

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The GP Clinic

Medical Letter Questionnaire

Membership Details

Health and Fitness Information

Membership Cancellation Request

Doctor's Information

Additional Information

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Priority options: *

Confirm your details

Terms

Do you agree to the above Terms? *

Coupon Code

Medical Letter Questionnaire

Membership Details

Health and Fitness Information

Membership Cancellation Request

Doctor's Information

Additional Information

Checkout

Priority options: *

Confirm your details

Terms

Do you agree to the above Terms? *

Coupon Code

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