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Fees for services not provided under the NHS The services shown are not provided under the National Health Service contract and so the following fees will be charged. If you have any questions relating to these fees, please address them to your Doctor or the Practice Manager before requesting the service. General Private Prescription Simple Certificate (e.g. private letter, incapacity certificate) Complex Certificate (2 or more pages long requiring examination of past medical records) Private Sick Note Driving License Application countersignature Childminder Ofsted Health Declaration Form Other Childminder Form (simple) Blue Badge (disabled parking) Bus Pass (Now Card) Power of Attorney Examination and Certificate Witnessing Power of Attorney £ 13.00 £ 20.00 £ 35.00 £ 15.00 £ 20.00 £ 65.00 £ 40.00 £ 30.00 £ 20.00 £ 80.00 £ 40.00 Medical Examinations HGV / LGV / PSV / COACH / BUS / TAXI Elderly Driver Report (without examination) Elderly Driver Examination and Report Pre-Employment Report (without examination) Pre-Employment Examination and Report £100.00 £ 55.00 £ 95.00 £ 99.00 £165.00 Medical Records Computer printout Copying Medical Records (incl. patient requests) Copying Medical Records (extract) Viewing Medical Records £ 10.00 £ 50.00 55p £ 10.00 Insurance Private Insurance Claim Forms Medical Assessment Reports (Price set externally) Medical Assessment Report (without examination) Medical Assessment Examination and Report Sport Fitness for Gym Sports Report (detailed) Sports Medical Elizabeth Street Surgery Private Fees (November 2015) per copied sheet £ 30.00 £ 99.00 £165.00 £ 30.00 £ 35.00 £ 99.00
