Certificate, referral, sick pay request

We help you conveniently manage your official requests. Below, we inform you how to request a certificate, a referral, or a document for sick leave from our practice.

Call during ordering hours

A doctor is filling out a medical certificate.

Mother and little daughter at a medical consultation

Convenient administration

You will soon be able to submit these requests via an online form, so you won't need to visit the clinic in person. Until the forms are ready, please submit your request by phone at +36 1 406 81 93 or by email at medicminikft@gmail.com. Our staff will be happy to assist you.

Pediatrician

Careful, quality care

Child-friendly environment

Online Forms

You can submit the following requests directly via the online form.

Request for a Referral

For children registered at this practice only.

Request for a Referral

Child's first name

Child's Last Name

Date of Birth

TAJ number

Address

Country

Zip Code

County

City

Line 1 of the address

Line 2 of the address

We process the personal and health information provided on this form for the purposes of reviewing your application, providing health care, and handling related administrative matters.

I have read the Privacy Notice, am familiar with its contents, understand it, and accept it.

Request for a Certificate

For children registered at this practice only.

We will be able to prepare the certificates this evening; in the meantime, we ask for your patience. Thank you!

Request for a Sick Leave Certificate

Please fill out all fields.

Request for a Sick Leave Certificate

Child's first name

Child's Last Name

Date of Birth

Address

Country

Zip Code

County

City

Line 1 of the address

Line 2 of the address

First Day of Sick Pay

Last day of sick pay

Parent's First Name

Parent's Last Name

Parent's Date of Birth

Her mother's first name

Her mother's last name

Parent's TAJ Number

Parent's Place of Employment

Parent's Job Description

Description of the Complaint

We process the personal and health information provided on this form for the purposes of reviewing your application, providing health care, and handling related administrative matters.

I have read the Privacy Notice, am familiar with its contents, understand it, and accept it.

Contact: phone +36 1 406 81 93, e-mail medicminikft@gmail.com. For further contact information, please visit our Contact page.