To Whom It May Concern Letter Request

If you require a formal letter, or on behalf of a patient at the patient’s request, based on medical facts existing on your/their file please complete and sign this form.

Opinions which are not supported by, or do not necessarily follow from these facts may be disregarded.

Please note, if the letter is needed by:

  • 3 working days the charge is £90
  • 7 working days the charge is £50
  • 14 working days the charge is £30

Selecting an option and signing the form commits you to paying the appropriate fee mentioned above.

Please note that the GP may not be in a position to write the letter if there is no evidence in your medical record to support your claim.

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.