Jessop Medical Practice

Greenhill Lane, Leabrooks, Alfreton, DE55 1LU

Telephone: 01773 602707

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

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Eating Disorders

First Steps

“For children and their families, young people, and adults affected by eating difficulties and disorders
Our founding principles are based on the experiences of individuals who have had, are still living with, and have recovered from eating disorders and comorbid mental health conditions.”

You can access their website here or call 0300 1021685

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

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Jessop Medical Practice

Eating Disorders

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