Specialist Referral Letter

Referral reason

Tell us what you need this specialist referral letter for.

What is the main reason for this referral? *

Many patients use this service for Right to Choose ADHD / autism referrals, insurance claim support, or housing / employer letters — pick the closest match.

Please select a referral reason

Your condition

Help our doctors understand what you’re dealing with and what you’ve already tried.

Please describe the issue you would like referred *

10 words minimum.

0 / 10 words minimum

Please provide at least 10 words

What have you already tried? *

If nothing, please write None.

Please tell us what you have tried (or write None)

When did your symptoms first appear? *

Please enter the date your symptoms started

Medical background

Background on medication and underlying health issues for the referring doctor.

Are you currently taking any medication? *

Please answer this question

Please list the medication you take *

Please list your medication

Do you have any other underlying health issues? *

Please answer this question

Please list your health issues *

Please list your health issues

Specialist details

If you have a specific specialist or clinic in mind, let us know. All fields on this step are optional — leave blank if you don’t have a name.

Specialist’s full name

Optional — skip if you don’t have a specific specialist.

Specialist’s field of practice

Optional — the medical area or specialism you’re being referred to.

Specialist clinic address (optional)

Postal code (optional)

City (optional)

Street address (optional)

Your NHS GP

For your safety, it helps our doctor to know who your regular GP is.

Are you registered with a UK NHS GP? *

Please answer this question

NHS surgery name *

Please enter your surgery name

NHS GP address (optional)

Post code (optional)

Please enter the post code

City / Town (optional)

Please enter the city or town

Street address (optional)

NHS number

Optional — found on any NHS letter, prescription, or NHS app.

Supporting documents

Please record a short video explaining your reason for the referral, and upload a photo ID.

What we need

A short video (up to ~2 minutes) describing your reason for the referral in your own words
A photo of your ID or passport
A recent selfie so we can verify identity
Any supporting documents (optional) — past test results, hospital letters, NHS app screenshots, etc.

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 describing your reason for the referral

Up to ~2 minutes. Film yourself explaining what you’d like referred and why — this helps the doctor write a strong letter.

Our doctors can only begin working on the letter once this is received.

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Tap to upload or drag & drop

MP4, MOV — max 100MB

Please attach a photo of your ID as proof of identification

Accepted forms of ID include: 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.

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Tap to upload or drag & drop

JPG, PNG, PDF — max 10MB

Take a selfie

A clear, recent photo of you so we can verify your identity.

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Tap to upload or drag & drop

JPG, PNG — max 10MB

Supporting documents (optional)

Past test results, hospital letters, NHS app screenshots, prior prescriptions, etc. Upload multiple files if helpful.

Optional — upload anything that will help the doctor write a better letter.

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Tap to upload or drag & drop

JPG, PNG, PDF — max 10MB each

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.)

Your details

We need your name exactly as it should appear on the letter, plus how to reach you.

First name *

Please enter your first name

Last name *

Enter your name exactly as it should appear on the referral letter.

Please enter your last name

Date of birth *

Please enter your date of birth

Sex *

Please select an option

Email address *

Where the letter will be delivered.

Please enter a valid email address

Phone number *

Please enter a valid phone number

Review your details

Please check everything is correct before proceeding to payment.

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.

Specialist Referral Letter £47

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Specialist Referral Letter

Referral reason

Your condition

Medical background

Specialist details

Your NHS GP

Supporting documents

Your details

Review your details

Payment

Consultation Submitted