Application Form | Doctor's Letter for Travelling With Medication
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Section 1: Your Details

Full Name
Your certificate will be sent to this email address
Date of Birth
Address

Section 2: Your Travel Plans

The airport or location you will be departing from
The airport or location you are travelling to
Do you have a return flight booked?
Do you know of any specific regulations or restrictions regarding your medications at your destination?

Section 3: Medical History

Section 4: Medications

Please provide the following details: NAME, DOSAGE, and QUANTITY of each medication you are taking on your trip.
Click or drag files to this area to upload. You can upload up to 100 files.
Please make sure all the medications you plan to travel with are clearly visible on your prescription or online health record.

Section 5: Identity Verification

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Section 6: Anything Else? (Optional)

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Terms and Conditions

By submitting your application, you confirm your acceptance of our Terms and Privacy Policy and agree to the following:

  1. The medications listed are prescribed solely for your personal health needs by a registered healthcare professional.
  2. The information you have provided is accurate, complete, and truthful to the best of your knowledge.
  3. You understand that Wilmer Health is not a substitute for in-person medical consultations, and the healthcare professionals at Wilmer Health do not have access to your NHS or primary GP medical records.
  4. The letter you are requesting is issued for the individual whose name and details have been provided in the application.
  5. You acknowledge that Wilmer Health does not offer diagnosis, treatment, or consultations, and accepts no liability for any adverse events that may occur.
  6. You absolve both Wilmer Health and its doctors from any liability for adverse events that may affect you or others.
  7. You understand that Wilmer Health cannot guarantee acceptance of its letters or certificates by third parties, such as airlines or authorities, and is not responsible for any costs incurred if they are rejected.
  8. Once a doctor has reviewed your request and provided a letter, you understand that no refunds will be issued.
  9. If any of the information you provided is found to be false or misleading, the certificate issued will be considered invalid.
  10. You acknowledge that all the medications you intend to travel with are clearly visible on the prescription or online health record you have submitted.
Agreement to Terms and Conditions

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