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. The doctor may call you or arrange for an appointment. If you have already been seen by your Doctor about this illness your certificate will be sent to you within a week.

Last Updated: 01/10/2021

Your Details

Full Name *

Date of Birth *

Address *

Phone Number *

Email Address

Sick/Fit Note

Describe your illness and why you require a Fit/Sick Note *

Date the Sick Certificate needs to run from. This is the date your previous sick note runs out, or 7 days after the onset of your illness *

How long your Sick Certificate is required for. This will be at the GP’s discretion, but you may have been advised by the hospital how long you should expect off work. *

What is the exact date you plan on returning to 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 for more than 7 days

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