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The Doctor will assess your request and your case will be reviewed before issuing your certificate. We may call you for further information or you may need to be seen.
Name
Date of Birth
Address
Address Line 1
Address Line 2
Email Address
Re-enter Email Address
Certificates will not be issued for conditions not already diagnosed by your GP
Yes I have seen the GP regarding this condition
Medical reason for cert
From what date?
Duration (nr of weeks)
Note
I agree with being contacted by phone, email or SMS text
Certificate cost:
€25
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