How do I get a fit note, and when do I need one?
The first week is self-certified, a range of healthcare professionals can now issue a fit note, and the "may be fit for work" option is the part employers and employees both overlook.
- Difficulty
- beginner
- Time
- 15 min
- Read
- 3 min
Short answer
You self-certify for the first seven calendar days of sickness absence, including non-working days. After that an employer can ask for a fit note. Nurses, occupational therapists, pharmacists and physiotherapists can issue them as well as doctors, they can be issued digitally without a wet signature, and they do not have to be provided on the eighth day exactly.
The fit note replaced the sick note in order to say something more useful than "not fit for work". It has a second option — may be fit for work — with tick boxes for a phased return, altered hours, amended duties and workplace adaptations. Used properly it is the mechanism for getting someone back to work sooner rather than a certificate of absence.
Step by step
- Self-certify for the first seven days.Seven calendar days, including weekends and non-working days. Employers use their own self-certification form, and cannot require a fit note for this period. Asking a GP for one is a waste of an appointment.
- Check what your employer actually requires.Some employers do not ask for a fit note for short absences beyond seven days, and some occupational health schemes have their own process. The contract or handbook says.
- Contact your practice, but not necessarily for a GP.Since 2022, nurses, occupational therapists, pharmacists and physiotherapists can also legally certify and issue fit notes. Many practices route these requests away from GP appointments entirely — ask what their process is.
- Ask about a hospital-issued note if you were treated there.Following an inpatient stay or hospital treatment, the hospital team can issue the fit note. That is quicker than going back to the practice for it.
- Understand the two options on the form."Not fit for work" and "may be fit for work taking account of the following advice", with tick boxes for a phased return, altered hours, amended duties and workplace adaptations, plus space for comments.
- Know that "may be fit for work" is advice, not a requirement.If the employer cannot accommodate the suggested adjustments, the note is treated as though it said not fit for work. No further note is needed for that, which is a widely misunderstood point on both sides.
- Give it to your employer, not to DWP.Fit notes go to the employer for sick pay purposes. Benefit claims have their own evidence requirements, and DWP may ask for the fit note separately.
- Get a further note before the last one expires.A gap between notes complicates sick pay. Note the end date and request the next one a few days before, particularly around bank holidays.
- Keep copies.They are evidence for sick pay, for any later benefit claim, and for any dispute about the absence. A digital fit note can be forwarded and saved.
Questions people ask
How long can I self-certify?
Seven calendar days, including non-working days. An employer cannot require a fit note for that period, though they can require their own self-certification form.
Does a fit note have to come from a GP?
No. Nurses, occupational therapists, pharmacists and physiotherapists can legally issue them, and hospital teams can issue one after treatment. Many practices deliberately route these requests away from GP appointments.
What does "may be fit for work" mean for me?
It sets out adjustments that would let you work. If your employer can accommodate them, you return on that basis. If they cannot, the note is treated as "not fit for work" and no further note is required.