Illness Certs | The Rise FP

Illness Certificates

You must attend for a GP consultation to receive an illness benefit certificate (to claim for a social welfare

payment) or medical certificate for your employer.

To open your claim for social welfare you can apply online here.

If you need to extend the period of certification, you may submit the below form and we will contact you if you need to be reviewed by the GP.

First Name

Last Name

Date of Birth (dd/mm/yyyy)

Phone

Full Address

Certificate Start Date

Certificate End Date

Reason for cert (not required)

I confirm that I am requesting an extension of an existing cert. (Please make an appointment to see a GP if you have a new medical issue.)

I consent to this message being sent electronically to the practice. I have checked that the email address and phone number supplied are correct and consent to receiving medical information via email or text.

By submitting this form you will be sending personal/sensitive information about yourself across the Internet. Please read our privacy statement to discover how we protect and manage your submitted data. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of contacting the practice.

Illness Certificates

Contact

Opening Hours

Links

For Life Threatening Emergencies - Call 999 or 112