Sick (fit) note request

First date you were not at work due to this illness:

Please use this date format: DD/MM/YYYY.

How long do you need the note to last?

The doctor will decide based on your submission and your medical record how long the sick note will last, but please add a preference eg. 1 week, 1 month

Total number of days you were ill or state ongoing:

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

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