Fitness to Work Request / Sick Note for less than 7 days

The sick note is referred to as a Fitness to Work Certificate. Your GP is entitled to charge you for a Fitness to Work Certificate when the illness has been for 7 days or less.

It is not always necessary to visit your Doctor in order to receive a Fitness to Work Certificate.

Please complete this form. Someone will be in touch from the practice to explain when you will receive the Fitness to Work Certificate and to arrange payment.

You must be registered with this practice to submit this form. 

Fitness to Work Request

Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY.
Include holidays and weekends, not just days off work.