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 you were ill or state ongoing:

Have you self-certified for the first 7 days?

Yes

No

Please confirm the date your self-certification ended:

Please self certify for the first 7 days by visiting our Self Certification Sick / Fit Note for less than 7 days page.

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

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