Requesting an additional Sick Note (Fitness to Work Certificate)

Please complete this form if your state of health means that you are unable to work when a recent sick note (‘Fitness to Work Certificate’) ends.

The doctor may call you or arrange for an appointment.

If the doctor has enough information to issue a new sick note, we will try to have this ready for collection within 48 hours.

It is not normally necessary to see a doctor before your return to work at the end of the sickness period and you can go back to work sooner if you feel well enough.

Additional Sick Note Request

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