Doctor’s Sick / Fit Note for more than 7 days

If you have been ill for more than 7 days you will need a doctor’s certificate. These certificates are called ‘Fitness To Work’ Certificates.

If you have not already seen a doctor regarding this illness, you will be required to make an appointment to request a sick note.

Please only use this form if you are requesting a sick note for an illness the GP has seen/treated you for recently.

If we need to contact you regarding the submission of your form, we may respond directly through the website and aim to do this within 10 working days of receipt of your form. You will be notified of any responses via email. Please remember to check your email account’s spam/junk folder.

Sick / Fit Note Request

Sick / Fit Note Request

If you are human, leave this field blank.

Full Name: *

Date of Birth: *

Please use this date format: DD/MM/YYYY.

Phone Number:

Email Address: *

Responses we send will go to this email address

First date you were not at work due to this illness:

The date you need this sick / fit note to commence. Please use this date format: DD/MM/YYYY.

Date of planned return to work:

Length of required time for sick / fit note. Please use this date format: DD/MM/YYYY.

Describe your illness and why you need a Sick / Fit Note:

*

I confirm that I am currently within the UK at the time of sending my enquiry.