Doctor’s Sick/Fit Note

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. The doctor may call you or arrange for an appointment if they need more information about your illness or condition. If you have already been seen by your doctor about this illness, or there is enough information in your medical records, your certificate will be sent to you within a week.

Last Updated: 21/11/2023

Your Details

Full Name *

Date of Birth *

Phone Number

Email Address *

Sick/Fit Note

Tell us the first date you were not at work because of this illness *

Describe your illness or condition and why you need a sick/fit note. *

How many days were you away from work? Or is the illness still ongoing? *

If the illness is still ongoing, how long do you think you will be away from work?

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data. *

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Doctor’s Sick/Fit Note

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