Sick (fit) note request

Sick / Fit Note Request

First date you were not at work due to this illness:

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

Total number of days unwell in this period:

Have you self-certified for the first seven days of illness?

Yes

When do you need the certificate to start?

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

When do you expect to return to work?

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

How would you like your certificate sent to you?

Text message

Paper copy for collection

Describe your illness and why you need a Sick / Fit Note:

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