Doctor’s Sick / Fit Note for less than 7 days

The Doctor’s note is referred to as a Fit Note. Your GP is entitled to charge you for a Fit Note when the illness has been for 7 days or less.

It is not always necessary to visit your Doctor in order to receive a Fit Note.

Please complete this form. Someone will be in touch from the practice to explain when you will receive the Fit Note and to arrange payment.

Sick / Fit Note Request

If you are human, leave this field blank.

Full Name: *

Date of Birth: *

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

Phone Number:

Email Address: *

Date your illness started:

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

Number of days you were ill:

Include holidays and weekends, not just days off work.

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

Would you like us to send you text messages?

Yes

Please note that the details you give will be used to update your medical records.

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