E Contact Doctor’s Sick/Fit Note (for more than 7 days) 2023

If you have been ill for more than 7 days you will need a doctor’s certificate. These certificates are called ‘Fitness To Work’ Certificates. The doctor may call you or arrange for an appointment. If you have already been seen by your Doctor about this illness your certificate should be ready within a week.

Last Updated: 26/05/2023

Your Details

Full Name *

Date of Birth *

Phone Number

Email Address *

FIT (SICK) NOTE DETAILS

Have you already had a note about this? *

THE SURGERY WILL BE IN CONTACT WITH YOU REGARDING YOUR REQUEST WITHIN 5 WORKING DAYS, THIS COULD BE VIA TELEPHONE, TEXT OR EMAIL AND I AGREE NOT TO CONTACT THE SURGERY UNTIL AFTER THIS TIME REGARDING THIS REQUEST. *

I agree to the above statement

If possible, is there anything your employer could do to help you return sooner? E.g. could you work from home, do fewer hours, or do different tasks at work? *

Tell us briefly about your illness or medical problem *

When would you like the note to start? *

When do you think you can return to work? *

This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Cookies on the The Harefield Practice website

E Contact Doctor’s Sick/Fit Note (for more than 7 days) 2023

Further Information

Connect With Us