Request a Non-NHS Service or your Medical Report

Please use this form to submit your request for a non-NHS service or a medical report request.

Please take a moment to carefully read through this form and ensure you complete all the questions accurately to facilitate seamless access to our online services.

Request a Non-NHS Service or your Medical Report

Section

Non-NHS Service

At times you may need us to provide evidence of your health status or write a report for insurance companies or other organisations. The majority of these reports fall outside of the remit of what the NHS requires GP practices to provide. So, there is often a charge which depends on the nature of the request. Please use this form to submit your request. It may take up to 2 weeks for you to receive your letter or report from the date you submit your request to allow us time to deal with it.

Housing letters

The practice no longer provides housing support letters. We have been informed by the council that they are no longer required and do not influence their independent medical assessments in any way. We can however provide a medical summary of your medical history and current medications which you can submit with your application. If the council require more information, they will write to us and we will let you know.

You can also contact Islington Council housing services directly: via email HomesandCommunities@Islington.gov.uk, by phone 020 7527 5300, or in person at 222 Upper Street, London N1 1XR. Opening hours are 9am to 5pm Monday to Friday. Please call/attend Islington Council to make an appointment.

Islington Council: Contact Housing Services

Certificates:

Private Sick Note for Employer

Please use this format: DD/MM/YYYY
Please use this format: DD/MM/YYYY
*

Holiday Cancellation

*

Fitness to Travel

*

Reports:

Private Health Claim Forms (e.g. BUPA, AXA)

Is there a form we need to complete? *

Please hand in your form to reception.

*

Life Insurance / Critical Illness

Is there a form we need to complete? *

Please hand in your form to reception.

*

Employer's Report and Opinion (Without Examination)

Is there a form we need to complete? *

Please hand in your form to reception.

*

Employer's Report and Opinion (With Examination)

Is there a form we need to complete? *

Please hand in your form to reception.

*

Met Police Medical History Questionnaire

Is there a form we need to complete? *

Please hand in your form to reception.

*

Royal Air Force / Army Medical

Is there a form we need to complete? *

Please hand in your form to reception.

*

Medical Examinations:

Private Medical Examination with Report

Is there a form we need to complete? *

Please hand in your form to reception.

*

Adoption / Fostering Medical Paid for by Local Authority

Is there a form we need to complete? *

Please hand in your form to reception.

*

Driver Examination (HGV, LGV, Elderly, Taxi Medical)

Is there a form we need to complete? *

Please hand in your form to reception.

*

Letter Confirming BCG Scar (Required Examination)

*

Letters:

Miscellaneous Letters (University, Schools etc.)

*

Confirmation of Medication

If you require a list of your medication, we can provide this for free.

If you need us to write you a letter, addressing a third party, listing your medication, there is a £10 charge.

Please specify what you need: *
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Confirmation of Registration

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Blue Badge Support

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Any Occupational Health Form

Is there a form we need to complete? *

Please hand in your form to reception.

*

Medical Report Request

If you would like to request a medical report or a copy of your medical records, please use this form. We will then contact you to obtain consent where necessary and arrange for you to send any relevant forms or documents securely. The majority of these services are considered non-NHS work and you will need to pay a fee. There is no charge for Subject to Access requests.

If you require Occupational Health services, please see our Occupation Health page.

What type of medical report do you require?