Injury and Accident Confirmation Certificates Questionnaire

Medical Evaluation

Have you sought medical treatment for this injury or accident? *

Yes No

Describe any medical tests or diagnostic procedures you have undergone as a result of this incident. *

Are you currently receiving medical treatment or therapy for this injury or accident? *

Yes No

Doctor's Assessment

Have you discussed your injury or accident with your GP regarding the need for an Injury and Accident Confirmation Certificate? *

Yes No

Did your GP conduct any medical examinations or assessments related to this injury or accident? *

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:

Injury and Accident Confirmation Certificates

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

Details of the Injury or Accident

Medical Evaluation

Doctor's Assessment

Confirmation Requirements

Additional Information

Checkout

Priority options: *

Confirm your details

Terms

Do you agree to the above Terms? *

Coupon Code

Medical Letter Questionnaire

Details of the Injury or Accident

Medical Evaluation

Doctor's Assessment

Confirmation Requirements

Additional Information

Checkout

Priority options: *

Confirm your details

Terms

Do you agree to the above Terms? *

Coupon Code

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