A fit note is issued by certain healthcare professionals. It provides evidence of the advice patients have been given about their fitness to work.

A fit note explains details of your condition. This'll help you and your employer think about steps to help you return to work.

A fit note can also be known as a:

• sick note
• sick line
• doctor's note
• medical statement

You can read more guidance on Fit Notes here.

From July 2022, a new version of the fit note has been introduced. It contains the name of the healthcare professional who has authorised the form. This means it doesn't need to be physically signed. Whilst this change is being rolled out the previous version of the fit note will still be legally valid.

7 days off sick or less

If you're off work sick for 7 days or less, your employer should not ask for medical evidence that you've been ill. Instead they can ask you to confirm that you've been ill. You can do this by filling in a form yourself when you return to work. download a self-certification template here

More than 7 days off sick

If you're off work sick for more than 7 days, your employer will usually ask for a fit note.

When you work out the number of days that you've been sick, you need to count all the days in a row you've been sick. This includes days that you do not usually work like weekends and bank holidays.

Many healthcare professionals can complete and issue fit notes as part of your care. This includes:

• a GP
• a hospital doctor
• a registered nurse
• an occupational therapist
• a pharmacist who works in a hospital or general practice
• a physiotherapist

Healthcare professionals who issue fit notes may vary depending on the area you live in.

Community pharmacists cannot issue a fit note.

A fit note will only be issued after a full assessment of your fitness to work. To do this, the healthcare professional may need access to your full medical record.

If they decide that your health affects your fitness for work, they can issue a fit note. They'll advise that you are either:

• "not fit for work"
• "may be fit for work"

The healthcare professional will choose the "may be fit for work" option if they think that you are able to do some work. This may not be your usual job. They may also advise that you get some extra support from your employer.

You should discuss this advice with your employer to see if you can return to work. For example, your healthcare professional may suggest possible changes, like:

• returning to work gradually, for example, by starting part time
• temporarily working different hours
• performing different duties or tasks
• having other support to do your job - for example, if you have back pain, avoiding heavy lifting

If your employer is unable to accommodate these kinds of changes, then the fit note is treated as though it said "unfit for work".

If your fit note has expired and you are still unwell, you can submit another request. Our healthcare professionals will review your request and may arrange a follow-up call with you before issuing a new certificate.

Fit note can be backdated, so there is no need to book an emergency appointment to renew your certificate. If you do attend an emergency appointment with the intention of getting a medical certificate, you will be asked to rebook.

There is never a charge from a healthcare professional for providing a fit note if you're off sick from work for more than 7 days.

For sickness of 7 days or less, a charge will be payable for us to provide a private medical certificate. Please refer to the non-NHS services fee list.

For example, some employers may request medical evidence from employees who repeatedly take time off sick, even if they're off work for 7 days or less. This is a private, non-NHS medical certificate.