Private Services List and Fees

From the 25th May 2018 we will no longer charge patients to receive a copy of their medical record.  If you require a copy of your medical record you will be asked to come in to collect your them from the surgery.  We will not post, fax or email your medical records.

Please review our list of Non NHS work that we offer at the practice, which attract a fee. This includes certificates, forms, medical examinations and various travel vaccinations.  The GPs are given one calendar month to respond to private requests certificates and forms.

Private Letter / TWIMC £18.00
Private Sick Certificate of Fact

Complex Letter/Certificate (2 or more pages requiring examination of medical records)



Private Prescription for Travel £15.00
Freedom from Infection Certificate £45.00
Sickness / Accident Insurance Form £45.00
Lighter Life Forms £45.00
Housing Letter (payable in advance) £18.00
Fitness to Exercise Certificate £45.00
Fitness to Fly Report £45.00
Cancellation Holiday letter (simple)

Cancellation Holiday Form / Letter (complex)



Written report without examination, providing a detailed opinion and statement on the condition of the patient.

This could include:

  • Accident or sickness insurance to support a claim for payment of benefit under accident or sickness insurance policy
  • Employment report pre-employment, or report on an employee, requested by an employer
  • Fitness for education to attend university, college, teacher and nurses training and, for dentists, completion of the form of application for first registration of a dentist issued by the GDC
  • Pharmaceutical trials report on suitability of patient to take part as non-patient volunteer
  • Private medical insurance: report on prospective subscriber to a private medical insurance (PMI) scheme (eg BUPA, PPP, WPA)
Driving Licence Application Form

VOC GP certificate

GP series 2

GP examination






Witness Power of Attorney Form £45.00
Power of Attorney Examination and Certificate £110.00
School Health Report £35.00
Letter for taking Meds on Plane £18.00
Life Insurance report £104.00
Occupational / Solicitor / Firearms Report £104.00
Completion of Childminder Health Form

Adoption and Fostering fees are usually paid by the prospective parent, sometimes by the adoption/fostering agency or authority.  This needs to be established prior to your appointment.

Form AH – Health Assessment, Prospective Carer

Form AH2 – Adult Health Update, Parent




Approx’ £80.00

Approx’ £80.00


All HGV, Taxi Medicals and Bus Medicals £125
Pre-employment Medical
(Including elderly driver fitness to drive)



Hepatitis B (single £30.00) £90.00
Cholera (oral – full course) £65.00
Hep A/B antibodies £45.00
Rabies (three injections) £165.00
Japanese Encephalitis (Adult – Two Injections) £120.00
Blood Group £45.00
Tickbourne Encephalitis (Adult –  1 year cover) £210.00
Tickbourne Encephalitis (Child – 1 Year Cover) £195.00
Meningitis £65.00
MMR (Over 16s) ask at reception

Payment must be made in advance of the examination/course.

We accept cash and cheques only.  Cheques should be made payable to ‘Dysart Surgery’.

Payment services for non-registered patients mush be cash only.

If you require further information please contact reception.