Request a private letter or form - Cwmfelin Medical Centre

The practice has a primary duty to provide services for the management of patients who are ill.

Writing letters and reports falls outside the NHS GP contract. This includes letters and reports for insurance providers, adoption and fostering, driving including DVLA, housing and benefit appeals, schools, health clubs and employers.

Private work and fees

When medical reports are provided, they are a private service. This means they must be completed in the GP’s own time, outside of their paid NHS working hours.

These services incur a fee. We set our fees with reference to the British Medical Association guidance on private fees.

Before we process your request

Please complete the form below.

We will advise you of the exact fee before processing your request.

About you

Full Name

Address

Date of Birth

For example, 15 3 1984

Day

Month

Year

Phone Number

Email Address

FURTHER INFORMATION

Reason for GP Private Letter Request (Practice Staff other than doctors or nurses will read this and there will be a charge for these requests)

Fit for Travel (Please provide more detail below)
For Local Authority (Please provide more detail below)
Housing (Please provide more detail below)
Legal (Please provide more detail below)
Other (Please provide more detail below)

Please provide a reason for your request

THIS FORM COLLECTS YOUR NAME, DATE OF BIRTH, EMAIL, OTHER PERSONAL INFORMATION AND MEDICAL DETAILS. THIS IS TO CONFIRM YOU ARE REGISTERED WITH THE PRACTICE, TO ALLOW THE PRACTICE TEAM TO CONTACT YOU AND ALSO TO UPDATE YOUR MEDICAL RECORDS HELD BY THE PRACTICE AND OUR PARTNERS IN THE NHS. PLEASE READ OUR PRIVACY POLICY TO DISCOVER HOW WE PROTECT AND MANAGE YOUR SUBMITTED DATA.

I consent to the practice collecting and storing my data from this form.

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