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Request a Patient Private Letter?

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Patient Private Letter Request

Required fields are marked with an asterisk (*).
I would like to request a Private letter (TWIMC)
Please provide your details below  
*Please note - You will receive an invoice via email or Text which requires paying via debit or credit card.  This letter request will not be processed until payment has been received. The letter will take 20 working days from the payment date to be produced
Teldoc will require you to upload a copy of photo ID to allow us to proceed with your request
* Please make sure all Mandatory fields have been completed
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Please note this form is not to be used for the following purposes:

Medical matters, Prescription requests, Patient Access requests, Appointment requests or Complaints. Medical matters cannot be dealt with via this form. If you have a query regarding a medical matter please telephone reception to make an appointment to see the appropriate person.

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