This form is used to apply for a Medical Certificate for Paternity Benefit.

Pdf

Medical Certificate for Paternity Benefit (PB3)

If you are self-employed, a doctor must complete this form to certify the expected due date of your baby (or the baby’s date of birth). This is required to confirm that you are entitled to paternity leave.

Download link for Download
View the file View
Help us improve our site

Do not include any personal details in the box below.
The information you submit will be analysed to improve the site and will not be responded to individually.

Was this page useful (required)
Maximum characters: 0 of 400
Submit