Fit Note Request

Section

Which note do you require? *

Not fit for work note

Specific reason for illness: *
This wording will appear on your note
Please use this date format: DD/MM/YYYY. Please note we cannot forward date a sick note so it will need to from today’s date or backdated.
Please use this date format: DD/MM/YYYY.

May be fit for work note

Specific reason for illness: *
This wording will appear on your note
Workplace adaptations: *
Please use this date format: DD/MM/YYYY. Please note we cannot forward date a sick note so it will need to from today’s date or backdated.
Please use this date format: DD/MM/YYYY.