Doctor’s Sick/Fit Note for more than 7 days

If you have been ill for more than 7 days you will need a doctor’s certificate. These certificates are called ‘Fitness To Work’ Certificates. The doctor may call you or arrange for an appointment. If you do not hear from the surgery, the sick note can be collected from the surgery the following day. Please note we do not post or email certificates.

Your Details

Full Name *

Date of Birth *

Phone Number *

Email Address *

Sick/Fit Note

FIRST DAY OF ILLNESS *

FIRST DAY OF FIT NOTE (7 DAYS FROM START OF ILLNESS) *

DESCRIBE YOUR ILLNESS AND WHY YOU NEED A SICK / FIT NOTE *

LENGHT OF TIME YOU WOULD LIKE THIS CERTIFICATE TO COVER *

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data. *

I consent to the practice collecting and storing my data from this form.

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Page last reviewed: 19 June 2026
Page created: 14 October 2022

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Doctor’s Sick/Fit Note for more than 7 days

Doctor’s Sick/Fit Note for more than 7 days

Further Information