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

Sick / Fit Note Request

Please use this date format: DD/MM/YYYY.
What is your current employment status? *
Are there any restrictions from stopping you returning to work?
Are there any restrictions from stopping you returning to education?
How long have you been unemployed for?
How would you like to receive your sick note? *