Fit (Sick) Note

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All questions marked with a * are mandatory

Initial questions
Are you a patient at Frome Medical Centre: *

As you are not registered at Frome Medical Centre, you are unable to request a Fit (Sick) Note.

You are unable to continue with this form: *
Fit (Sick) note

You do not need a sick note for the first 7 days of an illness - you can still self-certify your illness.

  • For isolating due to COVID-19 you can get an isolation note for up to 14 days via NHS 111 Online
Have you been off sick for more than 7 days?: *

If you have been ill for 7 days or less you don’t need to see a Doctor.

  • You can complete a Self Certification form yourself.
  • If your employer doesn’t have its own form your can complete the Employee's Statement of Sickness (SC2) form online. 
  • When you’ve filled in the form give it to your employer, it will help them decide if you can get Statutory Sick Pay. Keep a copy for your own information.

Some employers insist on a Doctor’s note regardless.

  • A Doctors note under these circumstances may involve a charge.
  • Please contact reception in these circumstances.
Have you already had a note about this?: *
Have you seen a clinician within the last month for the same problem you are requesting your Fit Note: *
E.g. could you work from home, do fewer hours, or do different tasks at work?

To issue a Fit (sick) Note you will need to see a Doctor

You are unable to continue to the next step (see above). : *
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Personal details

Please provide your details to help us find your record. If you are filling this in on behalf of someone else, please enter their details.

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Confirmation

Please check the details are correct

  • Name: 
  • Date of Birth (yyyy-mm-dd): 
  • Phone Number: 
  • Email Address: 

Have you already had a note about this?
Your Answer: 

Tell us briefly about your illness or medical problem.
Your Answer:

When would you like the note to start? When do you think you can return to work?
Your Answer:

If possible, is there anything your employer could do to help you return sooner?
Your Answer:

How should we contact you?: *
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