Any Simple Certificate (eg certificate of incapacity)
£15.00
More complex Certificate (eg BUPA, fitness to attend)
£30.00
Driving Licence photo card signature
£25.00
Letter for houseing/university/other short letter
£15.00
CLAIM FORMS
For insurance/accident/sickness/mortgage protection
£40.00
MEDICAL EXAMINATIONS/REPORTS
Record Extract
£50.00
Proforma
£75.00
Written Report (no exam)
£75.00
Full exam and report
(includes HGV/driving/seat belt exemption and pre-employment medicals)
£45.00 (30 mins) -
£90.00 (60 mins)
Supplementary Report
£20.00
TRAVEL
Fitness to travel certificate
£40.00
Passport countersignature
(at the discretion of the GP)
£25.00
Cancellation claim form
£40.00
Private Prescription (eg malaria/antibiotics)
£15.00
Freedom from infection letter
£15.00
SPORTS
Gym form - fittness to attend
£15.00
Fitness for gym/health-club certificate (examination)
£50.00
Sports medical with exam
£90.00
PRIVATE CONSULTATION
Non -EU residents
£50.00
ACCESS TO MEDICAL RECORDS
Request to be made in writing to the Practice Manager
£10.00
Photocopies of notes (manual or combined)
£50.00
Computerised only
£10.00
ADDITIONAL NOTES
There will be NO CHARGE for short letters confirming that a patient needs to take certain medications, such as Insulin/Morphine etc, abroad. These, where possible, will be handwritten and stamped during a patient's consultation.
There will be NO CHARGE for confirmation of illness preventing school examinations, providing a child has been seen with the illness. Again, where possible, these should be handwritten and stamped during the patient's consultation.
There will be NO CHARGE for housing letters
Please allow 3 working days of the particular GP specified for collection
Cunliffe Medical Centre, 41 Cunliffe Street, Chorley. PR7 2BA. Tel: 01257 267127. Fax: 01257 234665. Email: drshackleton@nhs.net
