Sick note request (MED3)

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Please note that for the first 7 calander days that you are unable to work through sickness you can complete a self certification form. This form can be obtained from your employer. NOTE: The Surgery cannot issue self certification forms.

If you are in hospital, they will provide you with a sick note. They should also include any period necessary after you leave hospital. If necessary, we can extend this when you return home.

After the first 7 days, you will need a sick note from us. If you feel you require time of work due to sickness and have not been reviewed my a medical professional then please call reception to arrange a review with our medical team. 

If you want to see your doctor solely to extend a current sick note OR have already been reviewed by one of our team then this does not need to be a telephone call. Please complete the form below and we will get back to you with the outcome. 

 Private Sick Notes


If you want a note to confirm sickness within the first 7 days of absence this will require a private note for which a fee is due.



1 Sick note request (MED3)

Please define the reason you are unable to work

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This information is retained for up to 28 days.

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Clarendon Lodge, 16 Clarendon Street, Leamington Spa, Warks, CV32 5SS
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