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Firearms Medical *NO Appointment Necessary *Book Today
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Consent Form
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*
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Step
1
of
4
25%
Your full name
*
Your Name
Date of birth
*
DD slash MM slash YYYY
Please Upload Your Medical Request Consent Form (Provided Above)
*
Max. file size: 128 MB.
Your address*
Address
Town/city
Postcode
Email
*
Phone
*
Are you applying for a grant or renewal?
*
Grant- First application
Renewal- Subsequent application
Your GP Details
Name of GP
*
Write N/A if no GP is assigned
GP Surgery Name & Address*
GP Surgery Name
Address
Town/city
Postcode
Email
*
Phone
*
Firearms Officer
Name
*
Write N/A if no officer is assigned
Firearms Licensing Police Force*
*
Avon and Somerset Constabulary
Bedfordshire Police
Cambridgeshire Constabulary
Cheshire Constabulary
City of London Police
Cleveland Police
Cumbria Constabulary
Derbyshire Constabulary
Devon and Cornwall Police
Dorset Police
Durham Constabulary
Dyfed-Powys Police
Essex Police
Gloucestershire Constabulary
Greater Manchester Police
Gwent Police
Hampshire Constabulary
Hertfordshire Constabulary
Humberside Police
Kent Police
Lancashire Constabulary
Leicestershire Constabulary
Lincolnshire Police
Merseyside Police
Metropolitan Police Service
Norfolk Constabulary
North Wales Police
North Yorkshire Police
Northampton Police
Northumbria Police
Nottinghamshire Police
Police Scotland
South Wales Police
South Yorkshire Police
Staffordshire Police
Suffolk Constabulary
Surrey Police
Sussex Police
Thames Valley Police
Warwickshire Police
West Mercia Police
West Midlands Police
West Yorkshire Police
Wiltshire Police
Unknown
Phone
*
Email
*
Your health and consent
Please note that our turnaround of 3 days begins when we receive your medical records from your GP surgery which can take up to 30 days.
Have you declared any medical conditions on your firearms/shotgun licence application/renewal form?*
*
Yes
No
Consent for Medical4firearms to carry out our full medical reporting process (please read thoroughly)*
*
I consent
I consent to Medical4firearms requesting my medical records from my GP and holding and reviewing my full medical records as part of my firearms/shotgun application or renewal. I also consent to any relevant medical conditions being disclosed on my medical report verification and subsequently reported to the police. I consent to my report being sent directly to the firearms licensing officer (in cases where the police accept this) or back to me by email/post in cases where the police require the report to be sent back to me. As per 2019 Home Office statutory guidance I consent to Medical4firearms writing to my GP surgery to request that my NHS GP adds a marker to my patient record (if such a marker is not already present on my patient record) to enable the NHS GP to flag up to police any new medical issues which emerge following the grant of the certificate.
Consent to report being sent to police by non NHS email*
*
For police forces that allow the report to be sent directly to them, please provide consent for us to email your report to the police via a non NHS email. Police guidance states that they cannot be held responsible for any loss or inappropriate access to emails sent to them from a non NHS email address. If you do not give consent we will send the report by recorded post only. For force areas that request that your medical report is sent back to you we will email you or post the report if you prefer.
I consent
I do not consent and accept that my report will only be sent to police by post
Print name for signature purposes
*
To confirm your consent, write your name.
Discount Code
Firearms Medical
Price:
Firearms Medical Free
Price:
Total
Credit Card
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