Gym & Health Club Cancellation Medical Certificate

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Your details

We need your name exactly as it should appear on the certificate.

Full name *

Enter your name exactly as it should appear on the certificate.

Please enter your full name

Date of birth *

Please enter your date of birth

Sex *

Please select an option

Contact details

We’ll send your certificate to this email address.

Email address *

Where the certificate will be delivered.

Please enter a valid email address

Phone number *

Please enter a valid phone number

About your membership

Tell us about your gym or health-club membership and what you need the certificate for.

Name of your gym or health club *

Please enter the name of your gym or health club

Do you need a certificate for suspension or cancellation? *

Suspension (temporary pause) Cancellation (permanent end of membership)

Please select an option

How long do you need the suspension for? *

Please tell us the expected duration

Main reason for your request

Select the reason that best describes your situation.

Main reason *

Serious illness Acute injury Surgery or hospitalisation Flare-ups of chronic condition Mental Health Crisis Distress due to bereavement Infectious disease Pregnancy-related concerns or complications Other

Please select a reason

Please describe your injury or illness *

Please describe your injury or illness

Please provide details of the surgery or hospitalisation *

Please provide the details

Wellbeing check

Please answer honestly. Your answers stay confidential and only help our doctors understand your situation.

Over the past month, have you had thoughts of suicide or self-harm? *

Please select an option

Have you ever attempted suicide? *

Please select an option

Are you having thoughts of suicide or self-harm right now? *

Please select an option

Urgent help is available

If you’re in crisis or having thoughts of suicide, please contact one of the services below:

Samaritans — Call 116 123 (free, 24/7) or email jo@samaritans.org
Papyrus (young suicide prevention) — Call 0800 068 41 41 or text 07860 039967
Childline — Call 0800 1111
NHS 111 — Call 111 for urgent medical advice

If you are in immediate danger, please call 999 or go to your nearest A&E.

Pregnancy or breastfeeding

This helps our doctors tailor your certificate correctly.

Are you currently pregnant or breastfeeding? *

Please select an option

Please provide details *

Please provide pregnancy details

Your condition

Help our doctors understand your injury or health condition.

Date of onset of health condition *

Please enter the date your condition started

Condition status *

Ongoing Partially Recovered Recovered

Please select your current condition status

Please describe your symptoms and how they stop you using the gym *

20 words minimum. The more detail you provide, the faster our doctors can review your case.

0 / 20 words minimum

Please provide at least 20 words

Have you seen a doctor about this?

Tell us if you’ve already sought care for this issue.

Have you sought medical care for this condition? *

Yes, from my GP or a specialist Yes, I visited A&E No, never consulted a doctor for this before

Please select an option

What treatment was administered? *

Please describe the treatment

Medical history

Any relevant background health information for our doctors. Both optional.

Please list any underlying health issues or past medical history

If none, please write None.

Please list any regular medication you take, whether prescribed or over-the-counter

If none, please write None.

Supporting documents

Please upload the documents below so our doctors can begin your case.

What to upload

To issue your certificate, please provide:

A short video (30s–1min) confirming your identity and describing why you can’t use the gym
A photo of your ID (driver’s licence, passport, residence permit)
Any clinical letters or A&E discharge notes (if available — optional)

If you do not have your documents to hand, you can email them to certificates@medicalcert.co.uk quoting your consultation reference number.

Short video (30 seconds – 1 minute)

Confirm who you are and briefly describe your condition and why it stops you using the gym.

Shot on your phone is fine. Our doctors can only begin working on the certificate once this is received.

🎥

Tap to upload or drag & drop

MP4, MOV, HEVC — max 30MB

Photo of your ID

Driver’s licence, passport, residence permit, or military ID.

We respect your data privacy and all personal information is processed confidentially and never shared.

🪪

Tap to upload or drag & drop

JPG, PNG, PDF — max 10MB

Clinical letters or A&E discharge summary (optional)

Upload any supporting medical documents — GP letters, hospital notes, discharge summaries, prescriptions, etc.

🏥

Tap to upload or drag & drop

JPG, PNG, PDF — max 10MB

I will send the files via email to certificates@medicalcert.co.uk instead of uploading now. (Please note, our doctors will start on your case once we have received your documents.)

Review your details

Please check everything is correct before proceeding to payment.

I confirm that the information I have provided is accurate and complete to the best of my knowledge.

I consent to Medical Cert storing and processing the information I have submitted, including health information, in order to provide this service.

I understand that Medical Cert is unable to process refunds once a medical letter has been written and sent to me.

I agree to the Terms and Conditions (https://medicalcert.co.uk/terms-and-conditions/) and Privacy Policy (https://medicalcert.co.uk/privacy-policy/).

Disclaimer
Any medical certificate is void if information is later discovered to have been falsely disclosed or deliberately withheld. The certificate does not guarantee any specific outcome but represents the considered opinion of the doctor based on the information available at the time. I absolve Medical Cert UK, Nobel Medical LLC, and their doctors of liability for any adverse events.

I have read and agree to the Terms and the Disclaimer above. *

You must agree to the Terms and the Disclaimer to continue

Payment

Secure checkout · Most approved certificates are issued same day or by 9AM the next day, delivered as a signed PDF direct to your inbox.

Gym & Health Club Cancellation £47

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Gym & Health Club Cancellation

Your details

Contact details

About your membership

Main reason for your request

Wellbeing check

Pregnancy or breastfeeding

Your condition

Have you seen a doctor about this?

Medical history

Supporting documents

Review your details

Payment

Consultation Submitted