Request a Private Medical Certificate for work or college

Note – the Medical Certificate is suitable for work and college absences. We do not state the reason for your absence but simply that you are “unfit for work / college”. We do not issue Illness Benefit claim forms IB1 nor social welfare medical certificates MED1.

Name of Patient that requires a Medical Certificate*

First Last

Date of Birth*

Date of Medical Consultation*

Start Date of Medical Certificate*

End Date of Medical Certificate*

Your Email*

Your Mobile / Cell Phone Number*

REPEAT Your Mobile / Cell Phone Number*

EIRCODE – 7 characters long*

https://finder.eircode.ie/#/

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Cert

Cert

Medical Certificate Request

Request a Private Medical Certificate for work or college

In a life-Threatening Emergency Dial 999 or 112