Sick Note

  • If you have not seen a doctor and this is your first request for a sick note do not complete this form, contact the surgery Tel: 01454 412599 and ask reception to book an appointment for you.
  • If you are suffering from a long-term problem that the doctor is aware of and will not need to see you in order to issue a note, please continue to use the e-form below to make a request.
  • Please allow 48 hours for your request to be processed before collecting it from the surgery.
  • Please note all fields must be completed for the form to be processed.
This form is sent to us in a non-ecrypted format.
Complete confidentiality for completing this type of form can not be guaranteed.
If you have an issue with this please feel free to send your reply by post.