updoc | 'Medical Letter' Consultation

'Medical Letter' Consult

For various purposes
I am seeking:*

Sick leave from workFit to start workFit to return to workAdjustments to work dutiesSick leave from studiesFit to resume studiesChickenpox recoveryTravel & holiday cancellationPregnancy fit to fly
Subscriber ID
Your Details
Full name of the person who requires the letter*

First NameLast Name
Email*
example@example.com
Mobile number*
e.g. 07438384646
Date of birth*

DayMonthYear
Ethnicity*
Sex*

MaleFemalePrefer not to say
Sex (for pregnancy letter requests) - hidden*

MaleFemalePrefer not to say
NHS number
Please leave blank if unsure or if you do not have an NHS number
Medical Questions
Medical Questions
Do you have any pre-existing health conditions your Partner Practitioner should be aware of?*

YesNo
Please provide information about your pre-existing health conditions.*
Are you taking any medications regularly?*

YesNo
Please provide information about your standard medication regimen.*
How far can you walk before you have to stop to catch your breath?*

Few hundred yardsLimited to 1 mileUnlimited
Personal Health Status
Are you currently suffering from any infectious diseases?*

NoYes
Are you presently sick due to any infections?*

NoYes
Did you ever have any infectious diseases in the past that necessitated isolation?*

NoYes
Have you previously been diagnosed with Tuberculosis?*

NoYes
Please detail any existing diseases or health conditions that you currently have. Please provide a timeline.*
NHS - GP Summary Care Record Upload

Provide images or screenshots of your NHS GP Summary Health Care Record. It should provide your current medical history, past medical history, current medications, and immunisations. You can request this 'Health Summary' from your GP. It may also be available in your NHS app, if you have linked it with your NHS GP Surgery.
Please upload your NHS - GP Summary Care Record

Optional field
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Please provide the address where we should send your certificate.

A hard copy of your certificate, signed in wet ink, is often needed for your visa application. We will mail you this signed certificate, free of charge, via Royal Mail, in addition to your digitally signed certificate.
Address*
Health Certificate - Country Confirmation
Specify the country requiring this health certificate.*
When is your estimated delivery date?*

DayMonthYear
Your Partner Practitioner is unable to certify you as fit-to-fly if your gestation is of 36 weeks or over.
Is your pregnancy single or multiple?*

SingleMultiple
Did conception occur naturally or with the assistance of medical procedures (e.g., IVF, fertility treatments)?*

NaturallyWith the assistance of medical procedures
Please specify the method(s) used to conceive. *
Have you experienced any complications or adverse events during your current pregnancy?*

NoYes
Please specify the complications or adverse events experienced (e.g., hypertension, vaginal bleeding):*
Have you noticed any recent changes in your abdomen, such as pain, bloating, changes in bowel habits, or cramping?*

NoYes
Please specify the changes in your abdomen (e.g., pain, bloating, bowel changes, cramping):*
Have you recently experienced any chest discomfort, such as cough, chest pain, shortness of breath, or palpitations?*

NoYes
Please specify your chest symptoms (e.g., cough, chest pain, shortness of breath, palpitations):*
Do you have a history of any of the following medical conditions?*

Anaemia/low blood cell countSickle cell disease or traitHistory of blood clotsHigh blood pressurePoorly controlled diabetes (high blood sugar)Complications during previous pregnancies (such as vaginal bleeding)Placental abnormalitiesHistory of early onset of labour (before 37 weeks)2nd trimester miscarriage(s)None of the above
Have you been medically advised that you are NOT at increased risk for conditions such as pre-eclampsia, hypertension, blood clots, or premature delivery?*

I have been advised that I am NOT at increased risk for these conditionsI have been advised that I am at increased risk for one or more of these conditions
Please confirm that your midwife does not advise against flying*

I have been medically advised that I may fly during my current pregnancyI have been medically advised NOT to fly during my current pregnancy
Please list any non-pregnancy related health conditions you currently have (e.g., asthma, migraine, chronic back pain):*
Are you currently on any prescribed medications?*

NoYes
Please list the medications you are currently taking (e.g., levothyroxine, aspirin):*
Please confirm whether you have been prescribed any medications to prevent blood clots (e.g., aspirin, heparin, or other anticoagulants).*

No, I have not been prescribed any medications to prevent blood clotsYes, I have been prescribed medications to prevent blood clots (e.g., aspirin, heparin, or other anticoagulants)
Where is your antenatal care being managed?*
What was your Body Mass Index (BMI) at the onset of your pregnancy?*

Underweight: Below 18.5Normal: 18.5-24.9Overweight: 25-29.9Obese: 30 or above
What was your latest antenatal clinic blood pressure reading?*

Low (below 90/60mmHg)Normal (over 90/60mmHg, below 140/90 mmHg)High (over 140/90 mmHg)
When was your most recent blood pressure reading taken?*

Within the last month1-3 months ago3-7 months agoOver 7 months ago
I understand that if I am issued a fitness to fly letter, I am flying at my own risk. I acknowledge that if there are any undisclosed changes or inaccuracies in the information I have provided, my Partner Practitioner is not responsible for any complications that may arise during or after the flight. If I become aware of any changes that may increase my risk of flying, I understand that I will no longer be fit to fly and should refrain from doing so.

As per NHS guidance, I am advised to drink plenty of water, move regularly during the flight (every 30-45 minutes), and wear graduated compression stockings. I have also been advised against flying to areas with a risk of Zika virus or malaria and to update my regular doctor and Partner Practitioner if anything changes with my pregnancy.

I confirm that I will take precautions to reduce the risk of venous thromboembolism (VTE), including staying hydrated, moving regularly, performing calf exercises, and taking any prescribed medications to prevent blood clots.
Do you agree to the above statement?*

Agree
Your request
Please explain why you need a fit to start work letter.*

5 words minimum. What you type in here won't be added onto the letter.0/0
Symptoms
Your unforeseen illness or injury
Main reason for travel or holiday cancellation*

Serious illnessAcute injurySurgery or hospitalisationFlare-ups of chronic conditionMental health crisisDistress due to bereavementInfectious diseasePregnancy-related concerns or complicationsOther
Start date of symptoms*

DayMonthYear
Date you started to feel unwell
In one or more words, please describe your symptoms or condition*
Main reason for medical letter*

Common cold or fluHeadacheMigraineBack painPeriod painAnxiety, stress or depressionOther
Please describe the timeline and the details of your symptoms*

5 words minimum0/0
Do you want your Partner Practitioner to include health details and symptoms in your letter, or would you prefer a more generic approach to maintain privacy?*

Yes, include specific health details and symptomsNo, maintain a generic approach for privacy
Have you sought medical care from your GP or local A&E for your medical issue?*

Yes, from my GPYes, I visited my local A&ENo
Please upload your A&E discharge summary, if available

Optional field
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What treatment was administered in A&E or by your GP?*
Video Evidence

Please upload a video lasting between 30 seconds to 1 minute, in which you describe your current symptoms and the reasons you may require a given outcome. Your medical information is confidential and will only be accessed by your Partner Practitioner as part of determining the suitability of issuing a suitable outcome.
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Condition Status*
Are your symptoms still ongoing, partially recovered or are you fully recovered?
Can you confirm that over the last 48 hours, no new spots have appeared, and that all the chickenpox spots have now scabbed over?*

YesNo
Have you had any fever within the last 48 hours?*

YesNo
Have you been in contact with anyone with Monkeypox?*

YesNo
How long do you need this for?

Please note, your Partner Practitioner may recommend different dates based on their professional judgment.
Valid from*

DayMonthYear
Date
Valid to (inclusive)

DayMonthYear
Date
Please be advised that while your Partner Practitioner may find it appropriate to recommend a leave period starting up to 28 days before the present date, they cannot retroactively issue the medical letter to reflect this earlier period.
Leave period starts before present date? (Hidden field)

YesNo
Current date

DayMonthYear
Date
Date calculation
Confirm your flight details
Flight Date

DayMonthYear
Date
Outbound flight date*

DayMonthYear
Please note that most airlines will only accept letters dated within 14 days of your outbound flight. Check your airline's policy.
Airline*
What is the duration of your flight?*

Short-haul flight: 1-3 hoursMedium-haul flight: 3-6 hoursLong-haul flight: 6-12 hours
How far along will your pregnancy be at the time of your outbound flight (in weeks)?*
Number of weeks pregnant. Your Partner Practitioner is unable to certify you as fit-to-fly if your gestation is of 36 weeks or over by your flight date.
Do you have a return flight?*

YesNo
Please be aware that your letter, if suitable, may allow you to travel on the outbound flight, however it will not advise on your eligibility for a return flight.*

I understand that my Partner Practitioner will not advise on my eligibility for a return flight.
Return flight date*

DayMonthYear
Date
How far along will your pregnancy be at the time of your return flight (in weeks)?*
Number of weeks pregnant. Your Partner Practitioner is unable to certify you as fit-to-fly if your gestation is of 36 weeks or over by your flight date.
Confirm your identity

Please upload an image of your Passport, Drivers License or University/College/Workplace ID to confirm your identity.
Identity Document (and/or Student ID if applicable)

Your photograph that is uploaded can be a PNG or JPEG image file, no larger than 20MB.
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Your workplace
I acknowledge that I do not hold any of the following roles for which fit-to-work notes cannot be provided: Any driving roles, motorsports drivers, HGV and bus drivers, taxi drivers, forklift drivers, ambulance drivers, crane operators, or work involving heights and scaffolding. Please confirm by selecting "I agree".*

I agree
Please confirm where you work*
Please describe your daily work activities*
What work adjustments do you require?*
e.g. To avoid using stairs, avoid pushing heavy objects
Your educational institution
Please confirm where you attend your studies*
Your NHS GP

Do you have a regular NHS GP?
NHS GP*
If Yes - please provide the name of your NHS GP Surgery ?
NHS Surgery
I confirm that I have fully understood the questions listed within this questionnaire and that they have been answered truthfully. I agree that any certification is only for the individual whose name and details were provided.*

Agree
Checkout

If your Partner Practitioner determines that telehealth is not appropriate for your case, you will be refunded.
Consultation Type - Pass to Stripe

Confirm your details

Please double check your details below. These will appear on the medical letter, if suitable, and can't be edited after submission.
Name: {fullName}
Date of birth: {dateOf40}
Sex: {sex68}
Email: {email}
Mobile: {mobileNumber}
Letter type: {iAm}
Workplace: {workplace}
Symptoms start date: {startDate} ({conditionStatus})
Valid from: {validFrom}
Valid to (inclusive): {validTo}
Name: {fullName}
Date of birth: {dateOf40}
Sex: {sex68}
Email: {email}
Mobile: {mobileNumber}
Letter type: {iAm}
Workplace: {workplace}
Name: {fullName}
Date of birth: {dateOf40}
Sex: {sex68}
Email: {email}
Mobile: {mobileNumber}
Letter type: {iAm}
Workplace: {workplace}
Symptoms start date: {startDate} ({conditionStatus})
Name: {fullName}
Date of birth: {dateOf40}
Sex: {sex68}
Email: {email}
Mobile: {mobileNumber}
Letter type: {iAm}
Educational institution: {pleaseConfirm}
Symptoms start date: {startDate} ({conditionStatus})
Name: {fullName}
Date of birth: {dateOf40}
Sex: {sex68}
Email: {email}
Mobile: {mobileNumber}
Letter type: {iAm}
Educational institution: {pleaseConfirm}
Symptoms start date: {startDate} ({conditionStatus})
Valid from: {validFrom}
Valid to (inclusive): {validTo}
Name: {fullName}
Date of birth: {dateOf40}
Sex: {sex68}
Email: {email}
Mobile: {mobileNumber}
Letter type: {iAm}
Symptoms start date: {startDate} ({conditionStatus})
Name: {fullName}
Date of birth: {dateOf40}
Email: {email}
Mobile: {mobileNumber}
Letter type: {iAm}
Type of pregnancy: {isYour}
Estimated delivery date: {whenIs}
Airline: {airline}
Outbound flight date: {outboundFlight}
Outbound flight gestation: {outboundFlight89} weeks
Name: {fullName}
Date of birth: {dateOf40}
Email: {email}
Mobile: {mobileNumber}
Letter type: {iAm}
Type of pregnancy: {isYour}
Estimated delivery date: {whenIs}
Airline: {airline}
Outbound flight date: {outboundFlight}
Outbound flight gestation: {outboundFlight89} weeks
Return flight date: {returnFlight}
Return flight gestation: {returnFlight92} weeks
Terms
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By submitting your consultation request, you acknowledge that you have read and agree to our Terms & Conditions and our Privacy Notice. Additionally, you consent to the following:
- You are NOT experiencing a medical emergency, serious medical condition, or any condition which requires immediate or urgent treatment;
- Your personal information (including health information) will be shared with all Partner Practitioners on the Updoc platform to enable continuity of care;
- You confirm that you have understood all the questions in the questionnaire and that all information you have provided, and will provide, to Partner Practitioners is accurate and truthful;
- Through Updoc, your Partner Practitioner does not issue Med3 notes, which are only obtainable through your NHS GP for UK government benefits;
- Your Partner Practitioner may require that you provide additional information to ensure they have the full picture.
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By checking this box, you confirm that you have read, understood, and agree to the above Terms:*

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'Medical Letter' Consult

Your Details

Medical Questions

Medical Questions

Personal Health Status

NHS - GP Summary Care Record Upload

Please provide the address where we should send your certificate.

Health Certificate - Country Confirmation

Your request

Symptoms

Your unforeseen illness or injury

How long do you need this for?

Confirm your flight details

Confirm your identity

Your workplace

Your educational institution

Your NHS GP

Checkout

Confirm your details

Terms