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

If you have been ill or absent from work for more than 7 days you should have already Self Certified (SC2). After this you will need a doctor’s certificate.

Please complete the form below to request your "Fitness for Work" certificate. This will not be processed until the due date. Allow 24 hours before collecting your certificate from the surgery.

Also be aware that this does not guarantee the GP will be able to fulfil your request as they may need further information regarding your absence.

Last Updated: 23/06/2024

Your Details

Full Name *

Date of Birth *

Phone Number *

Email Address *

Sick/Fit Note

FIRST DATE YOU WERE NOT AT WORK DUE TO THIS ILLNESS *

TOTAL NUMBER OF DAYS YOU WERE ILL OR IS STILL ONGOING *

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

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

Further Information