Doctor’s Sick / Fit Note Please telephone or visit your surgery if you’re injured, unwell or have an ongoing problem that cannot be treated at home. Sick/Fit note Full Name*Date of Birth*Phone Number*Email Address*Date you would like your sick/fit note to start* Date Format: DD slash MM slash YYYY Total number of days you would like your sick/fit note for*Describe your illness and why you need a Sick/Fit note*
