Requesting an extension to your Fitness to Work certificate

If you have already had a Fitness to Work certificate (Sick Note) for this illness your Doctor may not need to see you to issue an additional Fitness to Work certificate.

Please complete this form. The doctor may call you to clarify the information you provide and in some circumstances arrange for you to be seen. Unless you hear otherwise you can collect your Fitness to Work certificate from our reception desk after 3 working days.

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.