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Home > Fitness for work / Sick note Request

Fitness for work / Sick note Request

7 days off sick or less

If you’re off work sick for 7 days or less, your employer should not ask for medical evidence that you’ve been ill. Instead they can ask you to confirm that you’ve been ill. Download a self certification form: www.gov.uk/government/publications/statutory-sick-pay-employees-statement-of-sickness-sc2

More than 7 days off sick

If you’re off work sick for more than 7 days, your employer will usually ask for a fit note (or Statement of Fitness for Work – MED3) from a healthcare professional. Fit notes are sometimes referred to as medical statements or a doctor’s note.

Complete the form below to request a new or repeat Fitness for Work / Sick note.

Fitness for work / Sick note Request
DD/MM/YYYY
If known
Your Contact Details
Details

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


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Accrington Branch

387-391 Blackburn Road, Accrington, BB5 1RP

  • 01254 369123

Blackburn Branch

1A Pritchard Street, Blackburn, BB2 3PF

  • 01254 369123

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274 Union Road, Oswaldtwistle, BB5 3JB

  • 01254 369123
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