Jessop Medical Practice

Greenhill Lane, Leabrooks, Alfreton, DE55 1LU

Telephone: 01773 602707

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See our other Locations

Church Farm Primary Care Centre, Steeple Drive, Ripley, DE5 3TH | Telephone: 01773 602707

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Audiology (Hearing Issues)

For those over 55 with hearing loss and no other symptoms, you can self refer to these free service providers under the NHS Derbyshire Wide AQP Audiology Service. They will carry out hearing tests and also provide you with hearing aids if needed. This is also free.

Some of the providers below also provide home visits. Please click on the logo or call the numbers provided.

Important Information: Use this form to request a sick note (Med3). This form must only be used to request a sick note - any other requests via this route will be disregarded. Please only submit your request up to 24 hours before your sick note is due. We are not able to post-date sick notes.

Patient Name(Required)

First Last

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City County / State / Region Postcode

Patient Mobile Number

Patient Email

Is this a new request or extension of an existing sick note?(Required)

New sick note

Extension

Please let us know the start and end dates required for this sick note(Required)

Please tell us more about what you need(Required)

Please explain why you need the sick note

How would you like to receive your sick note?(Required)

Please make sure to include your email address or phone number if you'd like it emailing or texting.

Text message

Collection from surgery

Name

This field is for validation purposes and should be left unchanged.

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Jessop Medical Practice

Audiology (Hearing Issues)

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