Fees · Medical reports
Letters, reports and expert evidence.
Most requests need a letter, not a report, and a letter costs less. Fixed prices, hourly rates and individually scoped work are shown separately below, so you can see which one applies before you enquire.
Some services have a fixed price. Personal injury medico-legal work is charged at an hourly rate, and some expert work is individually scoped. Where a price is not fixed, a written estimate is agreed before work begins.
Each letter fee includes the stated assessment, the stated records allowance, the signed letter and one set of typographical corrections.
Records beyond the stated allowance, addenda and further questions are charged at the professional time rate, and only with prior agreement.
All medico-legal assessments and expert reports are independent professional opinions. No particular diagnosis, conclusion, causation opinion, prognosis, consistency assessment, recommendation or outcome can be promised or guaranteed.
Fees are payable for the expert's professional time, assessment, review of evidence and preparation of the report, irrespective of the conclusions reached.
The content of a report cannot be dictated by the patient, solicitor, instructing party or any other person.
Looking for what each report is and whether you need one? Start on our medical reports page. For a PIP claim, see the PIP report page.
Medical letters
A letter is the right product for most requests. If you need a short letter, you do not need a full report.
| Service and what is included | Typical length | Fee |
|---|---|---|
| Travel medication letterA 30-minute assessment and up to 15 minutes of records review. | 1 to 2 pages | £250 |
| Holiday cancellation medical letterA 30-minute assessment and up to 15 minutes of records review. | 1 to 2 pages | £250 |
| Fit-to-work certificate or letterA 30-minute assessment and up to 15 minutes of records review. | 1 to 2 pages | £250 |
| University or college short supporting letterA 30-minute assessment and up to 15 minutes of records review. | 1 to 2 pages | £250 |
| Fit-to-return or capability letterA 30-minute assessment and up to 15 minutes of records review. | 1 to 2 pages | £250 |
| Housing support letterA 30-minute assessment and up to 30 minutes of records review. | 2 to 4 pages | £500 |
| Unable to attend, sign or give biometrics letterA 30-minute assessment, up to 15 minutes of records review, and the timeframe addressed. | Signed letter | £350 |
| Severe mental impairment council tax formA 30-minute assessment, up to 15 minutes of records review and completion of the form. | Assessment and form completion | £250 |
| Severe mental impairment certificateA 60-minute assessment and the signed certificate. | 60-minute assessment | £300 |
| Knowledge of Language and Life in the UK waiver, form completionA 30-minute assessment and completion of the waiver form. | Form completion | £180 |
Each letter fee includes the stated assessment, the stated records allowance, the signed letter and one set of typographical corrections.
If you need a short letter, you do not need a full report.
This is an independent clinical opinion. It cannot be written to a required conclusion and does not guarantee the outcome of any claim, application, exemption or hearing.
Sick Notes and Medical Certificates
Every sick note and certificate is issued after a medical assessment.
| Service | Price |
|---|---|
| School Sick Note For pupils in school, up to the age of 16. | £65 |
| College Student Sick Note | £145 |
| University Student Sick Note | £145 |
| Pregnancy Fit to Fly Medical Note Includes a 30-minute assessment and a signed and stamped certificate. | £250 |
| Allergy Certificates Includes a 30-minute assessment and a signed and stamped medical letter. | £250 |
| Chickenpox Recovery Certificates Includes a 30-minute assessment, and evidence of varicella zoster vaccination or a documented history of chickenpox. | £180 |
Supporting Letters
| Service | Price |
|---|---|
| Gym & Health Club Letters Includes a 30-minute medical assessment, a physical health assessment and a fit to attend letter. | £250 |
| *All cases require a medical assessment |
Supporting reports
A report is longer than a letter and sets out findings, reasoning and an opinion.
| Service and what is included | Typical length | Fee |
|---|---|---|
| Detailed housing reportA 60-minute assessment and a full written report. | 5 to 8 pages | £750 |
| Disability supporting reportA 60-minute assessment and a full written report. | 5 to 8 pages | £750 |
| Blue Badge medical reportA 30-minute assessment and a written report. | 3 to 6 pages | £500 |
| Knowledge of Language and Life in the UK waiver, full reportA narrative report, for the cases where a narrative report is actually required. | 5 to 8 pages | £550 |
| Employment or reasonable adjustments reportA 45-minute assessment and a written report. | 3 to 5 pages | £495 |
| Comprehensive workplace or occupational reportA 60-minute assessment and a full written report. | 8 to 12 pages | £750 |
| Detailed university or mitigating circumstances reportA 60-minute assessment and a written report. | 3 to 5 pages | £550 |
| Workplace injury certificate or short letterAssessment and a signed certificate or short letter. | Certificate or short letter | £250 |
| Standard workplace injury reportAssessment and a written report. | 3 to 5 pages | £400 |
This is an independent clinical opinion. It cannot be written to a required conclusion and does not guarantee the outcome of any claim, application, exemption or hearing.
Personal Independence Payment
Independent medical evidence for a Personal Independence Payment claim, written about what you can and cannot do. Two products, both fixed price.
This is a private independent medical report. It is not a DWP assessment and it is not a guarantee of an award.
| Service and what is included | Typical length | Fee |
|---|---|---|
| PIP functional and medical assessment and reportAn assessment appointment of up to one hour and preparation of your written report. Report drafting is included in the fee; there is no separate drafting charge. The evidence-review scope is confirmed in writing before work begins. | Determined by the evidence and the agreed scope | £550 |
| PIP mandatory reconsideration and tribunal reportAn independent assessment of the relevant functional evidence together with the decision and assessment documents, and preparation of the written report. Legal representation, attendance at a hearing and separately instructed specialist reports are not included. | Determined by the evidence and the agreed scope | £900 |
DWP does not require you to obtain new medical evidence. You can send evidence you already hold, including copies of your records. Our fee pays for an assessment and an independent opinion, not for a result.
This is an independent clinical opinion. It cannot be written to a required conclusion and does not guarantee the outcome of any claim, application, exemption or hearing.
Both PIP products are explained in full, including what is assessed and what the fee covers, on our PIP report page.
Immigration
Independent medical evidence for immigration and asylum cases.
| Service and what is included | Typical length | Fee |
|---|---|---|
| Short immigration medical letterAssessment and a signed letter. | 2 to 4 pages | £550 |
| Standard immigration medical reportAssessment, records review and a written report. | 5 to 8 pages | £1,000 |
| Comprehensive immigration medico-legal reportAssessment, records review and a full medico-legal report. | 8 to 15 pages | £1,250 |
| Complex asylum or immigration expert reportAssessment, records review and an expert report. | Up to about 20 pages | £1,500 |
| Convicted-person immigration case, no prison visitAssessment, records review and a written report. No prison visit included. | Written report | £1,500 |
| Legal aid workUndertaken at the authorised rate only, with prior authority. | By instruction | Authorised rate only, with prior authority |
This is an independent clinical opinion. It cannot be written to a required conclusion and does not guarantee the outcome of any claim, application, exemption or hearing.
Personal injury
Privately funded personal injury medico-legal work is charged at £250 per hour. The hourly rate covers the consultation and examination, reading medical records and existing reports, analysis, and preparation of the report. A written estimate is agreed before work begins. Complexity changes the estimated time, not the hourly rate.
Travel, external investigations, separately instructed specialist opinions and court attendance are not automatically included. Any applicable additional costs are explained and agreed beforehand.
One set of reasonable typographical corrections is included. New evidence, substantive changes and expert questions are additional work, by prior agreement only.
Illustrative estimates
Illustrative only. These are worked examples of how time is estimated, not fixed packages, not measured average times and not a guarantee of the final fee. Actual hours are estimated after the case is scoped.
| Example | Why the work differs | Illustrative time | Illustrative total |
|---|---|---|---|
| Uncomplicated single injury, such as a resolved sprain or bruise, with a small set of relevant records | A focused history and examination, limited records and a relatively narrow report | Assessment 1 hour + records and analysis 1 hour + drafting and finalisation 1 hour = 3 hours | £750 |
| Multiple injuries with continuing symptoms and records from several treating teams | More chronology, comparison of records, consideration of pre-existing problems and a broader report | Assessment 1.5 hours + records and analysis 2.5 hours + drafting and finalisation 2 hours = 6 hours | £1,500 |
| Complex trauma with multiple injuries, extensive records and disputed attribution of symptoms | Substantially more analysis; some issues may need separately instructed specialists | Assessment 2 hours + records and analysis 5 hours + drafting and finalisation 3 hours = 10 hours | £2,500 |
These examples do not imply that all complex trauma is suitable for a GP report, and other specialists' fees are not included. Scope remains within Dr Parmar's competence.
Civil, criminal and clinical negligence expert work
Instructed work for solicitors, counsel and the court. The duty is to the court, not to the party paying the fee.
Personal injury medico-legal work
| Service and what is included | Typical length | Fee |
|---|---|---|
| Personal injury medico-legal workConsultation and examination, reading medical records and existing reports, analysis, and preparation of the report. A written estimate is agreed before work begins. | Charged for the time the case actually needs | £250 per hour |
| Minimum charge for substantive additional workApplies to substantive additional work agreed after the estimate, below one hour. It is not a surcharge on every task. | Per piece of additional work | £125 |
General civil expert work, non-personal-injury instructions only
| Service and what is included | Typical length | Fee |
|---|---|---|
| Preliminary desktop screening opinionReview of the papers and a short written screening opinion. Non-personal-injury instructions only; a personal injury instruction is charged at the hourly rate. | Screening opinion | £625 |
| Short CPR Part 35 GP reportExamination, records review and a Part 35 compliant report. Non-personal-injury instructions only; a personal injury instruction is charged at the hourly rate. | Short report | £1,250 |
| Comprehensive CPR Part 35 GP reportExamination, full records review and a comprehensive Part 35 report. Non-personal-injury instructions only; a personal injury instruction is charged at the hourly rate. | Comprehensive report | £1,500 |
| Complex multi-issue Part 35 reportScoped individually against the instruction and the volume of records. Non-personal-injury instructions only; a personal injury instruction is charged at the hourly rate. | Multi-issue report | From £2,000 |
| Qualifying MedCo workUndertaken under the applicable fixed-cost regime only. | By instruction | Applicable fixed-cost regime only |
Clinical negligence
| Service and what is included | Typical length | Fee |
|---|---|---|
| Preliminary clinical negligence merits or breach screenReview of the records and a short screening opinion on merits or breach. | Screening opinion | £750 |
| Breach of duty reportRecords review and a written report on breach of duty. | Written report | £1,500 |
| Causation reportRecords review and a written report on causation. | Written report | £1,500 |
| Breach of duty and causation combinedRecords review and a written report covering both issues. | Written report | £2,200 |
| Very complex cases or extensive recordsScoped individually against the instruction and the volume of records. | By instruction | From £3,750 |
Criminal
| Service and what is included | Typical length | Fee |
|---|---|---|
| Short CrimPR Part 19 reportAssessment and a Part 19 compliant report. | Short report | £1,250 |
| Standard criminal expert reportAssessment, records review and a written report. | Standard report | £1,500 |
| Complex criminal medical opinionAssessment, full records review and a written opinion. | Complex opinion | £2,200 |
| Preliminary criminal negligence screeningReview of the papers and a short screening opinion. | Screening opinion | £750 |
| Gross negligence type instructionScoped individually against the instruction. | By instruction | Individually scoped |
Istanbul Protocol
| Service and what is included | Typical length | Fee |
|---|---|---|
| Focused physical injury reportA one-hour examination, review of the papers and a focused report on the physical findings. Suitability and records screening is part of this work, so there is no separate screening fee. | Focused report | £1,500 |
| Comprehensive or highly complex Istanbul Protocol reportA 60 to 90 minute assessment, with the records review and the scope agreed individually against the instruction and the volume of records. An individual written estimate is given before work begins. | Usually up to about 20 pages | From £3,000 |
| Psychiatric or psychological opinionReferred for a separate specialist quote. | By instruction | Separate specialist quote |
This is an independent clinical opinion. It cannot be written to a required conclusion and does not guarantee the outcome of any claim, application, exemption or hearing.
Expert reports: amendments and supplementary work
An expert report is generally final once it has been completed, signed and issued. Where further work is properly required after issue, it is charged as professional time at the rate below, at the same rate as all other professional time.
Requesting an amendment does not guarantee that an amendment will be made. The expert will only amend a report where the amendment is professionally and evidentially justified.
| Service and what is included | Typical length | Fee |
|---|---|---|
| Post-report amendments and supplementary workSubstantive work after a report has been issued: consideration of new or additional records or evidence, substantive factual amendments, further analysis or reconsideration requested by the instructing party, responses to appropriate clarification questions, supplementary opinions, addendum reports, and revision of an opinion where further evidence properly requires the expert to reconsider or qualify it. Undertaken at the expert's professional discretion and by prior agreement. | Per hour | £250 per hour |
| Correction of a clear error made by the expertStraightforward correction of a typographical, transcription or other clear factual error attributable to the expert. This is not chargeable additional work and is distinct from a substantive amendment. | Per correction | No additional fee |
What post-report work covers, and how it is charged
Expert witness reports are generally considered final once completed, signed and issued. The expert's opinion is independent and based upon the clinical assessment, records and other evidence available to the expert. Instructing parties cannot require an expert to alter an opinion, conclusion or other substantive content merely because the findings are unfavourable or do not support their case.
Where appropriate, the expert may consider amendments or further work following issue of the report. This may include:
- consideration of new or additional records or evidence;
- substantive factual amendments;
- further analysis or reconsideration requested by the instructing party;
- responses to appropriate clarification questions;
- supplementary opinions;
- addendum reports; or
- revision of an opinion where further evidence properly requires the expert to reconsider or qualify the original opinion.
Any such substantive post-report work is undertaken at the expert’s professional discretion, by prior agreement, and is charged at £250 per hour. That fee pays for the additional professional work itself. It is not a fee for changing an opinion, and paying it does not entitle anyone to a different conclusion.
Requesting an amendment does not guarantee that an amendment will be made. The expert will only amend a report where the amendment is professionally and evidentially justified.
Errors made by the expert. Straightforward correction of a typographical, transcription or other clear factual error attributable to the expert will not ordinarily attract an additional professional fee. This is a correction, not a reconsideration, and it is treated separately from the substantive work above.
All medico-legal assessments and expert reports are independent professional opinions. No particular diagnosis, conclusion, causation opinion, prognosis, consistency assessment, recommendation or outcome can be promised or guaranteed.
Further work, court and travel
Charged only with prior written agreement.
| Service and what is included | Typical length | Fee |
|---|---|---|
| Professional timeAddenda, Part 35 or Part 19 questions, rebuttal, experts' meetings and trial preparation. Only with prior written agreement. | Per hour | £250 per hour |
| Minimum charge for substantive additional workSubstantive extra work below one hour. Not a surcharge on every task. | Per piece of additional work | £125 |
| Solicitor or counsel conferenceConference with the instructing solicitor or counsel. | Per 30 minutes | £125 per 30 minutes |
| Remote oral evidence, up to 2 hoursAttendance to give oral evidence remotely. | Up to 2 hours | £750 |
| Court or tribunal attendance, half dayAttendance at court or tribunal. | Half day | £1,250 |
| Court or tribunal attendance, full dayAttendance at court or tribunal. | Full day | £2,500 |
| Detention centre or prison attendance, half dayAttendance at a detention centre or prison. | Half day | £1,500 |
| Detention centre or prison attendance, full dayAttendance at a detention centre or prison. | Full day | £2,500 |
| Professional travel timeCharged with reasonable expenses in addition. | Per hour | £125 per hour, plus reasonable expenses |
Turnaround
One rule, for every letter and every report.
| Service and what is included | Typical length | Fee |
|---|---|---|
| Standard turnaround48 to 72 hours after the assessment and after we have all records and instructions. | 48 to 72 hours | Included |
| Priority 24-hour servicePlus 25 per cent of the fee, subject to the diary. | 24 hours | Plus 25% |
Complex PIP tribunal reports, multi-issue Part 35 reports and Istanbul Protocol reports may need a longer agreed window. That window is stated at quotation.
Terms
- Some services have a fixed price. Personal injury medico-legal work is charged at an hourly rate, and some expert work is individually scoped. Where a price is not fixed, a written estimate is agreed before work begins.
- Records beyond the stated allowance, addenda and further questions are charged at the professional time rate, and only with prior agreement.
- Clinically appropriate referral letters are included in your consultation fee. There is no separate charge for the referral letter. Any fees for appointments, tests or treatment with the receiving service are separate.
- A visit cancelled within 24 hours of the appointment is charged in full.
This is an independent clinical opinion. It cannot be written to a required conclusion and does not guarantee the outcome of any claim, application, exemption or hearing.
Prices effective 17 September 2026. Call the clinic on 020 8882 8088 if the service you need is not listed.
The personal injury hourly rate is £250 per hour. The general civil, criminal and clinical negligence package prices above apply to non-personal-injury instructions only. Reports are provided where clinically appropriate after assessment, and the opinion is independent.
Fees agreed before treatment, always
Know the cost before you begin.
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