Pre-consultation: Medical Certificates & Reports

First name *

Last name *

Email *

Phone *

Date of birth *

What type of medical certificate or report do you need? *

Select the type of medical you need. If you need a visa medical, please use our dedicated Visa Medicals form instead.

Who has requested this medical? *

Do you have a specific form that needs to be completed? *

If a specific form has been provided (D4, TPH/204, insurer's form, etc.), please bring it to your appointment. If you have it electronically, you can upload it below.

Yes - I have the form

No - I need a doctor's letter/report

I'm not sure

When do you need the certificate by? *

Some medicals (e.g. those requiring blood tests or GP records) take longer than others. If urgent, please let us know and we will do our best to accommodate.

Can you provide a copy of your NHS GP Summary Record? *

Some medicals (taxi/PHV, firearms, adoption/fostering) require the doctor to have access to your full medical records. You can download your GP Summary from the NHS App, or request it from your GP surgery. If you're not sure, we can guide you through the process.

Yes - I can get it from the NHS App

Yes - I will request it from my GP

No - I don't have a UK GP

I'm not sure how to get it

Do you have any current medical conditions? *

This includes diabetes, heart disease, epilepsy, asthma, mental health conditions, or any other ongoing condition.

Yes

No

Are you currently taking any medications? *

Yes

No

Do you have any history of the following? (select all that apply) *

These conditions are particularly relevant to driving medicals, safety-critical roles, and firearms assessments. Please be thorough - undisclosed conditions can invalidate your certificate.

Epilepsy or seizures

Diabetes

Heart disease or chest pain

Stroke or TIA

High blood pressure

Mental health conditions

Sleep disorders (sleep apnoea, narcolepsy)

Visual impairment

Hearing impairment

Neurological conditions

Substance use or addiction

None of the above

Have you had any surgery or hospital admissions in the last 12 months? *

Yes

No

Do you wear glasses or contact lenses? *

Driving medicals require a vision test. Please bring your glasses/lenses to the appointment.

Yes - glasses

Yes - contact lenses

Yes - both

No

How would you like your appointment? *

Most medicals require a face-to-face examination. Phone consultations can be arranged to discuss requirements and check that we can provide what you need before booking.

Face-to-face at our Westfield London clinic

I'd like to discuss my requirements by phone first

Is there anything else we should know? *

Any additional information, special requirements, or questions.

Here's what you've told us. Have a quick check, then hit send - this means your consultation can focus on what actually matters to you.

Your details

Name

Email

Phone

Date of birth

Type of Medical Required

What type of medical certificate or report do you need? -

About Your Medical

Who has requested this medical? -

Do you have a specific form that needs to be completed? -

When do you need the certificate by? -

Medical Records

Can you provide a copy of your NHS GP Summary Record? -

Medical History

Do you have any current medical conditions? -

Are you currently taking any medications? -

Do you have any history of the following? (select all that apply) -

Have you had any surgery or hospital admissions in the last 12 months? -

Do you wear glasses or contact lenses? -

Appointment

How would you like your appointment? -

Anything Else

Is there anything else we should know? -

Upload forms or documents

Upload any forms that need completing (D4, TPH/204, insurer's form, employer's form, etc.) or any supporting documents.

Click to upload files

Anything else for your doctor?