SickNotes

Continuation Medical Certificates- Sick Notes

For the first five working days off of any sick absence, you don't see the doctor for a sick note- you "self certify" by getting a certificate from the Post Office.

Only if you've had a previous sick note for an ongoing illness, can we do you a continuation sick note here, on line.

If the Doctor feels that he can do a Sick Note for you with out seeing you, your continuation Sick Note should be ready for you to collect at Reception between 8.00am & 12 midday, or 2 pm till 6pm, Monday till Friday, within two working days of completing this form..
If he feels he needs to see you, we will E Mail you suggesting you make an appointment.
A Sick Note can always be back-dated, so you SHOULDN'T request an urgent appointment for a Sick Note.
WE HAVE RECEIVED REPEATED REQUESTS FOR SICK NOTES FROM CRANKS WHO ARE NOT REGISTERED WITH US, AND WASTE OUR TIME AND THEIRS FILLING IN THE FORM.
PLEASE, ONLY PROCEED IF YOU ARE REGISTERED WITH US, AND YOU HAVE AN ONGOING ILLNESS FOR WHICH YOU ARE RECEIVING REGULAR SICK NOTES FROM ONE OF THE FILEY DOCTORS

E Mail Reliability & Confidentiality

Please understand this form will be transmitted by E Mail. E Mail is never guaranteed to be reliable and totally confidential- it will pass through our ISP's computers, for instance.

If you prefer not to use E Mail, please arrange a Sick Note at the hatch.

First, some basic information we need to identify you:-

Family Name (Necessary)

First Name(s) (Necessary)

Date of Birth (in form dd/mm/yyyy) (Necessary)

I

E Mail to whom we can reply (necessary)

What is the illness you require certifying? (will be on your last sick note) (necessary)

When date you want your Med 5 Sick Note to start? (in form dd.mm.yy)

What date do you think your new Med 5 Sick Note should run till? (in form dd.mm.yy)

What is your usual job?

Can you briefly explain why your illness prevents you from working?

Which Doctor at the surgery do you feel knows the most about THIS illness?

Is there anything else you think we should know that would help us sort out your sick note?

DO NOT WASTE OUR TIME IF YOU ARE NOT REGISTERED WITH ONE OF THE FILEY DOCTORS

Before proceeding, may we remind you once more of the Confidentiality Problems that E Mail poses. If you have concerns, you could print out this page now on your printer, and let us have a copy. But if you are happy to submit your details by E mail, please click on the button below to submit your form.