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 or routine care request

A medical statement about your fitness to work

Fit (sick) note

**If you have an urgent medical request after 4pm then you must call the surgery as your contact may not be reviewed until the following working day. If you need medical attention before this time please call NHS 111.

This system is checked by our clinical team multiple times a day, we aim to respond to your request within 1 working day / 24 hrs (excluding weekends and bank holidays). You can expect a response via Email, Text Message, Phone call or the NHS App.**

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/)

**Do not use this form to request help for new or ongoing symptoms**

[Get help for a medical problem](/patient-initiated/L85046)

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?

Patient information