Requesting an additional Sick / Fit Note

If you have previously had a Sick Note (Fit Note) for this illness your Doctor may not need to see you to issue an additional Sick Note. Please complete this form. We may contact you to arrange an appointment if necessary. Please ensure when you complete this form you enter the mobile number you wish your sick note to be sent to, ensuring it is the same number we have on our medical records for you.

If you are not able to receive a sick note via your mobile device please state clearly that you wish to receive a paper copy by post. Please allow 2 working days for processing. Collection is not available due to current covid restrictions within the surgery.

Sick / Fit Note Request

Sick / Fit Note Request

Section

Is this your first Sick / Fit note for this illness? *
Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY.