Sick Note Medical Certificate

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Your Details

Your name will appear exactly as entered on your certificate.

First Name *

First name is required

Last Name *

Last name is required

Date of Birth *

Valid date of birth required

Phone Number *

Valid phone number required

Sex *

Please select your sex

Are you pregnant or breastfeeding?

Yes No

Please provide details regarding your pregnancy

Email Address *

If you don’t receive your certificate within the expected timeframe, please check your spam folder.

Please enter a valid email address

Because you’ve mentioned anxiety or depression, we have a couple of brief wellbeing questions. These help our doctor provide the most appropriate support. Your answers are completely confidential.

In the past month, have you experienced any thoughts of ending your life? * There’s no wrong answer — we ask this so your doctor can ensure you have the right care.

Please answer this question

Have you ever acted on thoughts of suicide in the past? *

Please answer this question

One More Question

We want to make sure you have the right support right now.

Are you having thoughts of ending your life right now? *

Please answer this question

⚠ Please access urgent help Please seek mental health support immediately. You may also access one of the 24-hour support services below. Your safety is what matters most.

Samaritans — for everyone

Call 116 123 · Email [email protected]

CALM (Campaign Against Living Miserably)

Call 0800 58 58 58 (5pm–midnight) · Webchat

Papyrus — Young People

Call 0800 068 41 41 · Text 07860 039967

NHS 111

Call 111 anytime — they will help you find immediate support.

I confirm I have noted the support services above and agree to contact one today

Please confirm you have noted the support services

Your Condition

Your information is reviewed only by your assigned GMC-registered doctor (GMC: 7495073) and kept strictly confidential. We never share your data with third parties.

When did your symptoms start? * Enter the date your symptoms began

Please enter the symptom start date

Current condition status *

Ongoing — still experiencing symptoms Partially Recovered — improving Recovered — fully better

Please select your condition status

Have you received a certificate from us for the same condition before? *

Please answer this question

Update Since Last Visit

Since you’ve had a certificate from us before, please let us know if anything has changed.

Have any treatments or investigations taken place since your last submission? * Please provide an update on your condition if anything has changed.

Please describe any changes since your last submission

Your Symptoms

Include when symptoms started, how they’ve progressed, and how they affect your ability to work.

Describe your symptoms and timeline *

Add as much detail as you can — our doctors need enough to assess your case

Please describe your symptoms (minimum 10 words)

Have you sought medical care from your GP or local A&E? *

Yes — I saw my GP Yes — I visited A&E No — I haven’t seen a doctor for this

Please answer this question

What treatment was administered? *

Please describe the treatment received

Upload your A&E discharge summary (optional)

📎

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Your Work & Certificate Dates

Tell us about your work and the dates you need covered.

Workplace / Company / Institution *

Workplace name is required

Describe your daily work activities (optional)

Certificate start date * Start date

Certificate start date required

Certificate end date * Max 14 days from start.

End date must be within 14 days of start

Individual sick notes can only be issued for a maximum of 14 days. Extensions can be issued if you remain unwell beyond 14 days.

For very retrospective sick notes we may request documentation indicating when you were affected by your illness.

Medical History

Almost done. These details help our doctors provide the most accurate certificate.

Underlying health issues / past medical history I have no underlying health issues or past medical history to declare.

Regular medications I take no prescribed or over-the-counter medications.

Supporting Documents

Our doctors need to verify your identity and condition before issuing your certificate.

Medical Evidence (if available) Photo/video of your condition, prescription, NHS app screenshot, or a short selfie video describing your symptoms.

No formal diagnosis? If you suffer from anxiety, stress, or depression but do not have a formal diagnosis, please click here to complete the diagnostic questionnaire.

✓ Questionnaire completed — results will be sent with your submission.

🩺

Tap to select files, or drag & drop

Browse files

Photo ID Driver’s licence, passport, work badge, or residence permit. Your ID is used solely for this consultation and never shared.

🪪

Tap to select your ID photo

Browse files

⚠️

Documents not on this device? No problem — you can email them from your computer after completing this form. Send your files to [email protected] with your submission reference as the subject line. You'll receive your reference on the confirmation screen.

I will send the files via email to [email protected] instead of uploading now. (Please note, our doctors will start on your case once we have received your documents.)

Diagnostic Questionnaire

These are standard clinical screening tools (GAD-7 and PHQ-9). Your answers are confidential and reviewed only by your doctor. They help us provide more personalised care.

⚠️ Please answer all questions before continuing.

Review Your Submission

Please check everything is correct before submission.

✏️ Not sure about something? Tap any section below to go back and edit.

I agree that upon submitting my medical consultation, I acknowledge the Terms and Privacy Policy and consent to the following: I am NOT seriously unwell with any of the following symptoms: chest pain, shortness of breath, unrelenting severe headache, worsening severe abdominal pain, loss of vision, thoughts of suicide, confusion, ongoing bleeding, unable to swallow fluids or saliva, loss of limb sensation or control, facial numbness or weakness, slurred speech. I understand the questions in the questionnaire and answered them honestly. The requested letter is solely for the individual with the provided name and details. Medical Cert is not a replacement for a doctor’s visit. I confirm I do not think I need to see a medical professional in person. Medical Cert is not my primary doctor or GP, and the doctor issuing my certificate may be unable to access my NHS or regular GP medical records. Medical Cert facilitates access to private medical letters and does not issue Med3 notes. Medical Cert is unable to process refunds once a medical letter has been written and sent to you. If my symptoms persist, I agree to consult with my regular doctor or GP for further medical advice. I consent to having this website store my submitted information so they can respond to my inquiry.

I have read and agree to the Terms and Privacy Policy above, and confirm all my answers are accurate and honest.

You must agree to the terms to continue

Complete Your Order

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★★★★★

"2 hours — exactly what we needed, even outside office hours."

— M.E. L. · Trustpilot Verified

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Sick Note / Fit Note

£47

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Reference:

Sick Note / Fit Note Medical Certificate

What’s the reason for your medical letter?

Your Details

One More Question

Samaritans — for everyone

CALM (Campaign Against Living Miserably)

Papyrus — Young People

NHS 111

Your Condition

Update Since Last Visit

Your Symptoms

Your Work & Certificate Dates

Medical History

Supporting Documents

Diagnostic Questionnaire

Review Your Submission

Complete Your Order

Payment Confirmed