Application Form | Youth Camp or Trip Medical Certificate

Section 1: Your Details

Name
Your certificate will be sent to this email address
Date of Birth
Address

Section 2: Your Medical History

Do you have any pre-existing medical conditions?
Are you currently taking any medications?
Do you have any known allergies?
Have you undergone any significant medical procedures in the last 12 months?
Do you have any physical mobility restrictions or requirements?
Do you have any other medical conditions that were not listed above?

Section 3: Your Activity Plans

Section 4: Identity Verification

Drag & Drop Files, Choose Files to Upload You can upload up to 100 files.

Section 5: Anything Else? (Optional)

Drag & Drop Files, Choose Files to Upload You can upload up to 100 files.

Terms and Conditions

Upon submitting your application, you acknowledge our Terms and Privacy Policy and consent to the following:

  1. You confirm that you have understood all the questions in the questionnaire and have answered them truthfully.
  2. The certificate you are requesting is intended exclusively for the person whose name and details have been provided.
  3. You acknowledge the potential risks associated with this activity, including possible health complications, and accept full responsibility for your decision to participate. Merlin Health and our doctors bear no liability for any adverse events that may occur at any time.
  4. You agree to release Merlin Health and our doctors from any responsibility for any negative outcomes affecting you or others at any point in time.
  5. You understand that Merlin Health does not provide consultations. Our certificates are based solely on the information you have provided, indicating no reported contraindications to participate, to the best of our knowledge. This service does not substitute for a medical consultation, diagnosis, or treatment, and we assume no liability for any adverse events.
  6. You acknowledge that our certificates are meant to confirm, based on available medical evidence, that no contraindications to participation exist. These certificates are not guarantees, insurance policies, or medical indemnity coverage against potential health events.
  7. You recognise that Merlin Health is not a substitute for a visit to your GP or primary healthcare provider. Our doctors do not have access to your NHS or regular medical records.
  8. You confirm that no other healthcare professional has advised you against participation.
  9. You confirm that you have provided all relevant medical information and have not intentionally withheld any details.
  10. You acknowledge that once your certificate request has been reviewed by our doctor and the letter issued, no refunds can be processed.
  11. You understand that if a third party, such as an activity provider, rejects a certificate from Merlin Health, neither Merlin Health nor our doctors are liable for any related costs.
Agreement to Terms and Conditions

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Price: £49.00