Multi-Day Medical Certificates

Only $29*

Multi-Day includes 3 days and over. Fill in the form below to request your medical certificate.

Multi-Day Medical Certificate Request
Medical Information
What are you unable to attend?*
What is the first day you are unable to attend?*

DayMonthYear
Date
How many days will you be unable to attend?*
What symptoms have you been experiencing?*

Flu-like symptomsGastro symptoms (vomiting and diarrhoea)Headaches (including migraines)Mental health symptomsInjury-related symptoms
Please provide details on the symptoms you are experiencing
Will you see your doctor within the next day if your symptoms are not improving and attend your nearest emergency department or call 000 if your condition gets worse?*

YesNo
Does your employer require your symptoms to be included on the certificate?*

YesNo

Personal Information
Name*

First NameLast Name
Email*

Confirmation Emailexample@example.com
Mobile Number*
Date of Birth*

DayMonthYear
Date
What is the best number to reach you on?
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState

Post CodeCountry
Do you confirm that you understand the questions asked and that your responses are true and correct? Do you also confirm that you are required to have a telehealth consultation prior to a certificate issued? Do you also confirm that you understand this certificate cannot be used to avoid Police bail or matters relating to attending Court.*

Yes

Payment*

Medical Certificate Consultation Multi-dayA medical certificate for 3 or more days

$29.00AUD Quantity

Payment Processing FeeStripe payment processing charge

$0.98AUD

Total

$0.00AUD