Sick note request (also known as fit note)

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Sick note (Fit Note) request

For short-term illnesses lasting 7 days or less, you do not need a GP-issued fit note. You can self-certify for this period. For more information on self-certification, click here.

Please accept the following: *

I understand that my GP Surgery will only receive my consultation if I have completed it in full and have clicked "Finish" at the end.

Please confirm that you agree to our privacy and data sharing policy. *

I agree to my data being stored, shared, and used for further communication in accordance with the privacy policy which can be found here for Bramley, Middleton, and Cottingley, here for Briercliffe GP Surgery, here for Gateshead Healthcare, here for Queens Medical Centre and Lynton, here for the Mayflower Group, and here for Coleridge.

To ensure you receive the right care, we work with clinicians across the NHS, including local pharmacies. This means that your econsultation may be reviewed by a local pharmacist working for a local pharmacy or by one of our own staff members who will call you to discuss further if needed. For more information, click here. Please accept the following. *

I confirm that I am happy for either a clinical pharmacist from a local pharmacy or a clinician from my GP Surgery to contact me regarding my econsultation.

All subsequent questions during the online consultation are directed at the person requiring the online consultation. You should only complete this consultation for: a) yourself, (b) for someone else where you have their permission to do so, (c) for someone else where you are permitted in law (for example, a parent or guardian, carer, someone with power of attorney). Please indicate who you are completing this online consultation for: *

Myself
Someone else (I have parental responsibility or I am a carer)
Another person (with their permission or allowed in law)