Requesting an additional Sick / Fit Note

If you have already had a Sick / Fit Note for this illness your Doctor may not need to see you to issue an additional Sick / Fit Note. Please complete this form. We will contact you to let you know when you can collect your Sick / Fit Note or we may contact you to arrange an appointment.

Sick / Fit Note Request

Sick / Fit Note Request

Section

Date sick / fit note required from: *

Please use this date format: DD/MM/YYYY.

Number of days you were ill:

Include holidays and weekends, not just days off work.

Describe your illness and why you need a Sick / Fit Note:

Please note that the details you give will be used to update your medical records. If your correct contact information is not entered we will not be able to respond to you.

If you are human, leave this field blank.