Requesting an additional Sick / Fit Note

If you have already 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 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

Cannot be a future date. Please use this date format: DD/MM/YYYY
Provide estimate date. Clinician may need to amend. Please use this date format: DD/MM/YYYY