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.

Please note we ask for your Sex on this form in order to verify your records with the NHS.

Sick / Fit Note Request

Sick / Fit Note Request

Please use this date format: DD/MM/YYYY.
Do you already have a Sick / Fit note regarding this illness?
Please use this date format: DD/MM/YYYY.