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Study Medical Certificate

Thank you for completing this assessment for our Pocket Lab doctors to review. Medical certificates for students are issued at the doctor's discretion and they may call you to gather further information. Please expect a response within 2-4 hours between the hours of 8am and 10pm.

Answering the following questions will ensure you are using the most appropriate service today and help us issue your student medical certificate accurately.

Do you have any of the following symptoms which require immediate medical attention: chest pain, difficulty breathing, severe pain, severe headache, severe abdomen pain, uncontrolled bleeding, uncontrolled vomiting, dizziness, unable to swallow foods or saliva, weakness or numbness of the face or limbs, speech difficulty, eye pain or new changes in vision?

Please DO NOT proceed and please seek medical attention

Do you require cover for any assessments, including assignments, tests or exams, due to your absence?

This request requires a video telehealth consultation pleaseBook Here

How many days are you requesting for the medical certificate?

This request requires a video telehealth consultation pleaseBook Here

Do you need the medical certificate to cover any days before yesterday?

This request requires a video telehealth consultation pleaseBook Here

Have you been issued a medical certificate from Pocket Lab in the last 7 days?

This request requires a video telehealth consultation pleaseBook Here

Thank you, please complete the request details below

Submission

First name

Last name

Middle name

Email

Code

Phone

Address

Date of Birth

Gender *

Male

Female

Other

I am an international visitor or student

How long have you had symptoms?

Please describe your symptoms in detail including how they have changed over time and any treatments you have tried. ONE word responses will be automatically declined.

What is your place of study? For example school or university

How are your symptoms affecting your ability to study?

How many days are you requesting for the medical certifcate? *

1 day

2 days

What is the START day you are requesting for the certificate? We are able to issue a medical certificate commencing no earlier than one day before this consultation. *

Yesterday

Today

Tomorrow

Provide any additional information for the doctor here

I declare that, in my judgement, I do not require immediate medical attention. However, I will promptly seek medical assistance if any cause for concern arises.

I understand that a medical certificate is a legal document and I declare that the information supplied is true and accurate.

I consent to a doctor calling me should further information be required to complete my request.

I agree to the Terms and Conditions and Privacy Policyhere

Thanks for submitting!

Our Services

Medical certificates

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Contact

hello@pocketlab.nz

EDI: pocktlab

Call Centre Hours

8am - 5pm Monday to Friday

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