Request sick Paper (Fit Note)

Processing Time Notice:
Please allow 72 hours (3 business days) for your sick note request to be processed.

If you’ve been ill for 7 days or less:

You do not need to see a doctor.
Complete a Self-Certification Form instead.
- Most employers provide their own form—check with your workplace first.
- If your employer doesn’t have one, download the Self-Certification Form online .
- Print, fill it out, and submit it to your employer.

If you’ve been ill for more than 7 days:

You must obtain a doctor’s certificate (called a "Fit Note" or "Fitness to Work Certificate").
Please complete the form below:
- They may schedule an appointment or assess you via phone.

Requesting an Additional Fit Note for the Same Illness:

If you’ve already received a Fit Note for this illness:

Complete the form below
The surgery will contact you to:
- Confirm when your Fit Note is ready for collection, or
- Arrange an appointment if further assessment is needed.

Important:

Incomplete forms will be rejected.
Provide detailed information (e.g., illness duration, symptoms, impact on work) to help the GP assess your request.

Have you already had a sicknote?

Yes

Full Name

Date of Birth

Phone Number

Email Address

SICK/FIT NOTE

What is your Job?

DESCRIBE YOUR ILLNESS AND WHY YOU NEED A SICK / FIT NOTE

Have you sought any help to return back to work?

FIRST DATE YOU WERE NOT AT WORK DUE TO THIS ILLNESS

What date does your sick/fit note need to start?

How long do you anticipate you will need the sick paper to be?

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.

I consent to the practice collecting and storing my data from this form.

Yes