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2nd Floor, Akerman Health Centre
60 Patmos Road, London, SW9 6AF
Tel. 020 3582 0000
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Request A Sick Note
To get started, we will need to ask you a few questions...

How long have you been ill for?

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As 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. However, some employers insist on a doctor's note regardless.

Do you want to self certify or will you require a doctor's note?

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Is this your first sick note for this period of illness?

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Download the self certification form here:

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The Doctor's note is referred to as a Fit Note. Your GP is entitled to charge you for a Fit Note when the illness has been for 7 days or less.

Our fee for this service is £30. It is not always necessary to visit your Doctor in order to receive a Fit Note. Please complete the form below:

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As you have already had sick note for this illness, you may not need to see your doctor to receive a subsequent sick note.

Please fill in the form below:

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Since you have been ill for more than 7 days, you will need a consultation with the doctor.

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Your sick note request has been submitted.

You will hear from us within 1 working day.

Name:
Date Of Birth:
Address:
Postcode:
Contact Number:
E-Mail Address:
First Date Of Sickness:
Number Of Days Sick Note Is Required For:
Reason You Cannot Work:
Name:
Date Of Birth:
Address:
Postcode:
Contact Number:
E-Mail Address:
Existing Sick Note Start Date:
Existing Sick Note Finish Date:
New Sick Note Start Date:
Number Of Extra Days Sick Note Is Required For:
Reason You Cannot Work: