Requesting an additional Sick Note

If you have already had a Sick Note for this illness your Doctor may not need to see you to issue an additional Sick Note. Please complete this form. Please contact the surgery after 2 working days to confirm if your sick/Fit note is ready for collection.

Sick Note Request

Sick Note Request

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.
Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY.
The new date of your new sick note will be the date after the last sick note finished e.g. if your certificate expired on the 17th December, you will need to request the new note from the 18th December.