Undercliffe Surgery

01924 403406

Non-NHS services

The NHS does not pay for some of the services we provide. These include private sick notes, insurance forms, holiday cancellation forms, medical reports, fitness to travel certificates, private prescriptions and some vaccination services. Our fees for these services, which are in line with BMA approved national guidelines, are displayed in the surgery.





Certificates (signing)
Any simple Certificate/To whom it may concern

More Complicated Certificates

Private Sick Notes

Private Prescription

Certificate of Incapacity (employment)

Sickness/Accident Claim Form

Lasting Power of Attorney Form

Letters (To Whom It May Concern):-
Patients – taking medication abroad

Patients – to confirm they are registered

Patients – more complex letters requiring medical history / extract from records etc.

Data Protection Act
Copies of computerised Medical Records


Photocopies of Manual Records @ 35p per sheet


Full Medical with Report

Report only

Elderly Driver

Taxi Driver with Medical

HGV with Medical

Racing Driver

Seat Belt Exemption

Medical Reports without Examination

Medical Report with Examination

Army Report

Shot Gun Character Reference

Medical Examinations
Full Medical Exam with Report or Certificate

Pre-employment Medical with Report

School / University
School Fees Insurance Claim Form

Fitness to attend Medical and Report

Report only

Sports Fees
Fitness Exam/Certificate for Regulatory Body

Extract from records (fitness statement)

Fitness to Travel Certificate

Holiday Cancellation Certificate

More complicated Cancellation Certificate

ACWY Vaccination including Certificate

Vaccination Certificate

Hep B for Occupational             Health