Updoc UK Medical Letter Consultation

Medical Letter Questionnaire
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
Your Details
Full name of the person who requires the letter*

First NameLast Name
Email*

Confirmation Emailexample@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
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You agree to the processing of your personal data as described in our Privacy Notice, including for account creation, facilitating consultations, managing health records, providing customer support, improving our platform, and complying with legal obligations.

You have read and accept our Terms & Conditions.

You consent to receive marketing communications about relevant health services, promotions, or updates. You can withdraw your consent at any time.
Yes, I agree to the processing of my personal data as described in the Privacy Notice.Yes, I have read and agree to the Terms & Conditions.Yes, I consent to receive marketing communications. (Optional)
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Medical Letter Questionnaire