Request a sick note

Please be aware that this form can only be used for sick note requests. If you require medical attention then please call the surgery on 01925 847000 or use PATCHS here 

We are unable to pre-date sick notes so please only request your new note when the previous one is reaching the end date. We can back date your sick note if required so you are still covered for everyday you are off sick. Any requests sent more than 7 days before the end of your note will be rejected and you will be asked to submit the request again

If you have been off sick for less than 7 days then you must complete a self certificate form for the first week. You can complete a self certificate form here. If you are off sick for an extended period of time then please request a sick note below.

Please be aware that we cannot issue sick notes for children, for more information please click here