Medical Report

Questions we MAY
ask your GP
An example of the types of question that we MAY ask your GP/health consultant if we approach them
for a medical report.
Patient Records
From what date do the patient’s records in your possession begin?
If this period is not continuous, please give reasons (if you know them) for any gaps.

General Information
a. Last three height and weight measurements including waist size
b. Last three blood pressure readings
c. Last three cholesterol readings
d. Smoking habits
e. Drug use
f. Alcohol use

Specific Medical History

Additional details will be requested for any specific condition given during the application process.

Current Health
Is your patient having or waiting for any referrals, investigations or follow-up?
Details of any medication or treatment currently being received.
Details of any tests that have recently taken place or are awaited.

Recent Health
Please give details of ALL health record entries in the last 24 months.
Health History
a. Has your patient had a history of or symptoms of any of the following?
– Any type of cancer or malignancy
– A growth, lump or tumour
– A mole that has needed specialist referral
– Anxiety or depression
– Eating disorders
– Overdose
– Suicide attempt/self-harm
– Any other mental health issue
b. Has your patient had a history of or evidence of a condition affecting any of the following?
– The brain
– The heart
– The kidneys or bladder
– The liver
– The lungs
– The skin, eyes or ears
– The oesophagus, stomach or bowel
– The immune system
– The blood vessels or lymphatic system
– The endocrine system (e.g. diabetes)
– The musculo-skeletal system
– The nervous system
c. Has your patient had any test results which were either out of range, abnormal or required follow-up in the last 5 years?
Additional information would be requested for any positive answer given. This would include details about any consultation
with a health professional in relation to this condition. Examples of what information this may include are as follows:
the exact nature of the symptoms, treatment, referrals, investigations and their results, hospital admissions and time off work.

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