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Medical Letter Questionnaire

Before releasing your medical letter, our group of practitioners will review the evidence you submit. Only upon approval, shall you receive the medical letter via email including a unique reference number, which can be used to confirm its authenticity

I am in need of a Medical Letter regarding: Visa Medicals - Certificates of Good Health

Your Details

Full Name *

First Name

Last Name

Email *

Create Account?

Mobile Number *

Note: Your GP may reach out to confirm certain details.

Date of birth *

Address *

Sex *

Male Female Prefer not to say

Travel and Visa Details

What is the purpose of your visit (e.g., work, study, tourism)? *

Which country or countries are you applying for a visa to? *

Have you previously been issued a visa for the destination country? *

Yes No

Medical History

Do you have any known medical conditions or chronic illnesses? *

Yes No

Are you currently taking any prescription medications? *

Yes No

Have you ever been diagnosed with a contagious disease (e.g., tuberculosis, HIV/AIDS)?

Yes No

Vaccination History

Have you received vaccinations for diseases required by the destination country (e.g., yellow fever, COVID-19)? *

Yes No

Recent Illness or Exposure

Have you been recently ill or exposed to individuals with contagious diseases? If yes, please provide details of the illness and treatment received. *

Yes No

Travel History

Have you travelled to other countries in the past year? *

Yes No

Health Insurance

Do you have health insurance coverage that is valid in the destination country? If yes, please provide insurance details. *

Yes No

Additional Information

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?

Passport or Identification Upload

Please upload a scanned copy or clear image of your passport or identification for verification purposes.

Browse Files

Click here to upload file

Checkout

If your Partner Practitioner determines that telehealth is not appropriate for your case, you will be refunded.

Priority options: *

STANDARD REQUEST

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

£65.00

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.

£85.00

Hard Copy

£10.00

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:

Visa Medicals - Certificates of Good Health

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.
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.

Do you agree to the above Terms? *

Agree

Coupon Code

Subtotal	$0
Discount	$0.00
Hard Copy	$0.00
Total	$0.00

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