For urgent help, contact your GP. If they are closed, visit [NHS 111 online](https://111.nhs.uk/) or call 111. In an emergency [call 999](https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-call-999/)

If you need more urgent help, call your GP practice. If it's closed, visit [NHS 111 online](https://111.nhs.uk/) or call 111. In an emergency [call 999](https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-call-999/)

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I have an admin query

**The Integrated Care Partnership is open Monday to Friday from 8am to 6.30pm. The below admin query forms are open all the time.  We aim to respond to these within 2 working days. Medical queries are only taken over the phone on 01372 724434 during opening hours. Please do not submit any requests for appointments or medical advice through these forms.**

If you need more urgent help, call your GP practice. If it's closed, visit [NHS 111 online](https://111.nhs.uk/) or call 111. In an emergency [call 999](https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-call-999/)

If you're off work sick for **7 days or less**, your employer should not ask for medical evidence that you've been ill - **you do not need to complete this form.** Instead they can ask you to confirm that you've been ill by filling in a form when you return to work. This is called self-certification.

 **If you have been off work sick for 7 days or more, complete this form.**

Select if you've already had a note about this or not

Have you previously had a note about this?

Briefly describe your illness or medical problem

Enter a date in the past in the format DD MM YYYY, e.g. 31 12 2020

It is not possible to use a future date for a sick note.

Enter a date after the start date in the format DD MM YYYY, e.g. 31 12 2020

Provide an estimated date, but note that it might be amended by a clinician.

e.g. Work from home, reduced hours or different tasks

Can your employer do anything to help you return to work sooner?

Who is this request for?