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Consult Now
Referral
Medical Certificate

Consult Now Referral Medical Certificate

Step 1 of 5 20% Complete

What is this leave from?

Please note: Partner Doctors are unable to review fitness for work certificates.

I am seeking

Sick Leave

Carer's Leave

Please select a leave type.

The leave is from

Work

Studies

Other

Please select where the leave is from.

Step 2 of 5 40% Complete

What is the main reason for this leave?

Tell your Partner Doctor what's wrong.

Common cold or flu

Headache

Migraine

Back pain

Period pain

Anxiety, stress, or depression

Other

Please select a reason for the leave.

Step 3 of 5 60% Complete

How long do you need this for?

Partners Doctors might adjust the end date based on clinical appropriateness.

Fee Guide:

1-2 Days $27.50

3-5 Days $38.00

5+ Days $49.50

Fee is dynamically determined by the exact dates requested above. Based on the selected time period, your price range will automatically change.

From

Please select a start date.

Please select valid end date.

Step 4 of 5 80% Complete

Tell your Partner Doctor more

Please provide as much detail as possible to ensure an accurate review.

Symptom timeline & details

Optional file upload

Drag 'n' drop files here, or click to select

Step 5 of 5 100% Complete

Your information

Please provide your contact and residency details for the certificate.

Email Address

Please enter a valid email address.

First Name(s)

Please enter your first name.

Last Name

Please enter your last name.

Date of Birth

Please enter your date of birth.

Mobile number

Please enter a valid mobile number (8 to 10 digits).

Documents are sent via SMS and Email.

Street address

Please enter your street address.

Suburb

State

Postcode

Review your request

Please verify all details before proceeding to payment.

Leave Details

Reason

Duration

Application Fee

Patient Details

Name: -

DOB: -

Email: -

Mobile: -

Coupon code

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