Injury Confirmation Medical Certificate

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Your details

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

First name *

Please enter your first name

Last name *

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

Please enter your last 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

Reason for your certificate

Tell us why you need an injury confirmation letter.

What is the main reason for the medical letter? *

Please tell us the main reason for the letter

When did the injury occur?

Please enter the date of your injury or accident.

Date of injury or accident *

Please enter the date of your injury or accident

Current condition status

How has your condition progressed since the injury?

Condition status *

Ongoing Partially Recovered Recovered

Please select your current condition status

Describe your injury

Help our doctors understand what happened and how it affects you.

Please describe your accident or injury and current symptoms *

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

Medical care

Have you sought any medical care for this injury?

Have you sought medical care? *

Attended A&E Visited GP Have never sought medical care

Please select an option

Treatment administered

Briefly describe what treatment was given.

What treatment was administered? *

Please describe the treatment administered

Medical history

Any relevant background health information for our doctors.

Please list any underlying health issues or past medical history *

If none, please write None.

Please provide your past medical history (or write None)

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

If none, please write None.

Please provide your medication list (or write None)

Supporting documents

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

Medical Evidence

In order to issue your certificate, you will be asked to provide:

Evidence of your injury (copies of medical records, prescriptions, test results, NHS app screenshots, etc.)
A photo of your ID or passport

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

A&E discharge summary (optional)

If you attended A&E, please upload a photo/PDF of your discharge summary.

Optional — helpful but not required.

🏥

Tap to upload or drag & drop

JPG, PNG, PDF — max 10MB

Please upload medical evidence

E.g. photos of the injury, X-ray images, copies of medical communication, prescriptions, test results, screenshots from your NHS app.

Our doctors can only begin working on the certificate if this is received.

📄

Tap to upload or drag & drop

JPG, PNG, PDF — max 10MB

Please attach a photo of your ID as proof of identification

Accepted forms of ID include: photo of your driver’s license, passport, work badge, residence permit, or military ID card.

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

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 request that the clinical review begins immediately and I acknowledge that I will lose my right to cancel once the service has been fully performed.

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 represents the doctor’s considered opinion based on the information available. It does not guarantee fitness or any specific outcome. Nothing in this disclaimer excludes or limits liability that cannot lawfully be excluded.

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 · Where medically appropriate, most certificates are issued same day or by 9AM next day, delivered as a signed PDF direct to your inbox.

Injury Confirmation Medical Certificate £47

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Injury Confirmation Medical Certificate

Your details

Contact details

Reason for your certificate

When did the injury occur?

Current condition status

Describe your injury

Medical care

Treatment administered

Medical history

Supporting documents

Review your details

Payment

Consultation Submitted