Form

Get medical proof of domestic violence

Use this letter to get evidence of any illness, physical or mental harm caused by domestic violence, if you're applying for legal aid.

Documents

Sample letter: Specialist support service, request to provide referral confirmation from a health professional

This file may not be suitable for users of assistive technology. Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email web.comments@justice.gsi.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Health professional response to request for evidence of injuries/condition consistent with domestic violence

This file may not be suitable for users of assistive technology. Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email web.comments@justice.gsi.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

To ask for confirmation from the medical staff who treated you:

  • fill in the sample letter as best you can
  • send it to the doctor, dentist, midwife, nurse practitioner, psychologist or health visitor who saw you

If you can’t remember who treated you, contact your GP or the hospital you visited. Another health professional will be able to help.

You may have to pay a fee.

You can use the medical letter as evidence when you apply for legal aid to divorce or separate from an abusive partner.

Published 14 December 2014
Last updated 25 April 2016 + show all updates
  1. Sample letter updated.
  2. First published.