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

If you are human, leave this field blank.

Is this your first sick / fit note for this illness? *

Yes

When does your current sick / fit note expire? *

Sick note requests can only be taken 48 hours prior to an existing sick note expiring. If your note expires more than 48 hours from now, please wait to submit your request.

First date you were not at work due to this illness: *

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

Total number of days you were ill or state ongoing: *

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

How would you like to receive your sick / fit note? *

In the post

Electronically (email/online message)

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Requesting an additional Sick / Fit Note

Sick / Fit Note Request

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