Fit Notes (Sick Notes): Your Rights and the Rules

Data last checked on 2 October 2026.

A fit note, also called a sick note or a Med 3, is the proof of sickness you must give your employer once you have been ill for more than 7 days in a row. For 7 days or less you self-certify and do not need one. A fit note is free if you have been ill for more than 7 days.

Key points

✓You can self-certify for the first 7 days in a row, counting weekends and bank holidays. You need a fit note when you have been ill for more than 7 days in a row
✓A GP or hospital doctor, registered nurse, occupational therapist, pharmacist or physiotherapist can issue one after assessing you, but a community pharmacy does not have the form
✓A fit note is free if you have been ill for more than 7 days. A fee may be charged for evidence of 7 days or less, and your employer should pay it if they asked for it
✓A fit note covers at most 3 months at a time at first, and the healthcare professional can put a review date on it
✓It says either not fit for work or may be fit for work. If your employer cannot make the changes a may be fit note suggests, it is treated as not fit for work
✓You never need a note saying you are fit, and you can go back to work before the fit note ends without seeing your GP first
✓Universal Credit and New Style ESA also ask for fit notes, and you must keep them continuous. Northern Ireland has its own sick pay rules but the same 7 day self-certification

Do you need a fit note?

You do not need a fit note if you are fit for work, or if you are off sick for 7 calendar days or less, because you can self-certify for that time. The 7 days include weekends and bank holidays. You must give your employer a fit note if you have been ill for more than 7 days in a row.

For Statutory Sick Pay, the regulations say an employee cannot be required to provide medical information for the first 7 days in any spell of incapacity for work. Some employers' own rules ask for evidence earlier. DWP's guidance says that if an organisation requires medical evidence for the first 7 days, the healthcare professional may charge a fee and the employer should cover it.

A fit note is not only for employees. If you are not working, you may still need one to claim a health-related benefit from DWP, as the Universal Credit and ESA section below explains.

The fit note is the proof. How much sick pay you get and from which day is a separate question, covered in our Statutory Sick Pay guide.

Self-certification and the SC2 form

If you are off work for 7 days or less, you do not need to give your employer a fit note or other proof of sickness from a healthcare professional. When you return, your employer can ask you to confirm you have been off sick. This is called self-certification. You and your employer agree how you do it. You might need to fill in a form or send details of your sick leave by email.

GOV.UK has an official form for this, called SC2. You fill it in online and give it to your employer, and you should keep a copy. It can be used to self-certify a sick absence or alongside a fit note. You cannot save your progress, so get your details together first:

Yes: your National Insurance number
Yes: your phone number
Yes: details of your sickness, including the dates you were sick
Yes: the date of your last working day before your sickness began
Yes: your clock or payroll number

Your employer does not have to use SC2. HMRC's guidance says that for an illness of 7 days or fewer an employer may accept self-certification verbally or by letter, form SC2, or their own similar form. Check your employment contract for any agreed sickness procedure.

Telling your employer you are sick is a separate step from self-certifying. You must usually tell them before the deadline they set, or within 7 days if they have not set one, and you could lose some of your Statutory Sick Pay if you are late. An employer cannot insist that you tell them in person or on a special form.

Who can issue a fit note?

Since 2022 a fit note can be issued by any of these healthcare professionals, not only a doctor:

Yes: a GP or hospital doctor
Yes: a registered nurse
Yes: an occupational therapist
Yes: a pharmacist
Yes: a physiotherapist

The NHS says the pharmacists who can provide fit notes work at GP surgeries, hospitals and clinics. DWP's guidance for employers says community pharmacists do not have access to the Med 3 form, which is the technical name for the fit note. If you would rather have a doctor, you can ask for the fit note to be issued by a doctor, if one is available.

The healthcare professional has to assess you first. The law accepts a face-to-face appointment, a video call, a phone call, or considering a written report by another healthcare professional. A fit note is issued only if your health affects your fitness for work.

Your employer can agree to other evidence instead of a fit note. An Allied Health Professional Health and Work Report can be given by a physiotherapist or occupational therapist, and by other listed professions such as a paramedic, dietitian or podiatrist. It cannot be used to apply for Employment and Support Allowance. Private practitioners who do not treat NHS patients can produce a private medical certificate, which your employer can accept if they agree.

How to get a fit note

Contact the healthcare professional supporting your care

That is usually your GP surgery. After a hospital stay you may be given a printed fit note on discharge, and hospital staff should not send you to your GP just to get one.

Try the NHS App if your surgery offers it

The NHS says you may be able to request a fit note in the app. Select Appointments, then Request a letter or information, and answer the questions before you submit. If your surgery does not offer this in the app, contact the surgery directly.

Be assessed

The healthcare professional decides whether your health affects your fitness for work. Say how your health affects what you can do at work, for example your stamina and concentration, because the note is about work in general and not only your current job.

Check the note and keep the original

It must show the issuer's name, profession and the address of the practice. A note without the issuer's name or signature is not valid and can be rejected by your employer or DWP. The fit note belongs to you, and your employer can take a copy.

A fit note is not guaranteed. It may be issued depending on the healthcare professional's assessment of your fitness for work. If you work for two employers you get one fit note per assessment, show it to each employer and keep the original. A duplicate, clearly marked duplicate, is issued only if the original is lost.

What does a fit note cost?

Nothing, if you have been ill for more than 7 days when you ask for it. If your employer asks for evidence for the first 7 days of sickness, the healthcare professional may charge a fee, and the NHS says your employer should pay it. NHS GP practices must issue a fit note free of charge to the NHS patients they care for, but they might charge if you or your employer ask for one covering 7 calendar days or less.

What a fit note says

The fit note is formally called a Statement of Fitness for Work and was introduced in 2010. It records the effect of your health condition on your work. Each box on the form has a purpose:

Yes: The date you were assessed
Yes: The health condition or conditions affecting your fitness for work
Yes: The healthcare professional's assessment: not fit for work, which means not fit for work of any kind, or may be fit for work
Yes: Advice on how your employer can help, such as a phased return, altered hours, amended duties or workplace adaptations, plus a comments box
Yes: The period the fit note covers
Yes: Whether the healthcare professional will or will not need to assess you again at the end of the period
Yes: The issuer's name and profession, the date issued and the practice address

The regulations let the healthcare professional state your condition less precisely where disclosing the exact condition would harm your wellbeing or your position with your employer. Fit notes can be handwritten, or computer-generated and printed or sent to you digitally. A printed one from a healthcare IT system carries a barcode your employer can scan.

How long can a fit note last?

The length depends on the healthcare professional's clinical judgement. The regulations say the period cannot exceed 3 months unless you have been advised by a healthcare professional to stay off work for at least 6 months immediately before the assessment. After that, the healthcare professional can enter an indefinite period if they think you will not be fit for work for the foreseeable future.

Yes: Dates are inclusive. DWP gives the example of a fit note dated from 2 April to 10 April, which no longer applies from 11 April onwards
Yes: A fit note can be backdated. If your condition has affected you for some time without a previous fit note, the healthcare professional must enter an estimated date from which it did
Yes: A fit note cannot start in the future, because the date of the statement must be the date it is issued
Yes: A new fit note can be issued before the old one expires, if you are assessed again
Yes: A review date can be set to reassess you

If your fit note says you may be fit for work

May be fit for work means your healthcare professional thinks you could do some work with support. The note may tick one or more of four kinds of change, and the comments box can give detail:

Yes: a phased return to work: a gradual increase in work duties or hours
Yes: altered hours: changes to the times or duration of work
Yes: amended duties: changing duties to take account of a condition
Yes: workplace adaptations: changing aspects of the workplace, such as working from home

These options are not binding on you or your employer. Your employer should discuss them with you. If you cannot agree on changes, you must be treated as not fit for work, and you do not need to go back to your healthcare professional for a new note saying so. You can still get sick pay in that case.

If you are disabled under the Equality Act, your employer may also have a duty to make reasonable adjustments. Our reasonable adjustments guide explains it, and Access to Work can pay for some support.

Going back to work early, and fit for work notes

You can go back to work at any time you feel able, including before your fit note ends, and you do not need to see your healthcare professional first. The NHS says to talk to your employer if you feel well enough to return early, and your employer may ask for confirmation that you are fit, but healthcare professionals do not have to provide it.

There is no option on the fit note to say you are fit for work, and nobody needs to be signed back to work. If you are assessed as fit for work you are not given a fit note. For a small number of jobs there are separate procedures, such as the DVLA Form D4 for lorry and bus drivers.

What your employer can and cannot do with your fit note

Yes: They can take a copy. You keep the original in case you need it for benefits
Yes: They cannot withhold Statutory Sick Pay because your fit note arrives late
Yes: They should treat a not fit for work note as evidence for their sick pay procedures
Yes: They can ask you to be assessed again if they think you could do some work, but you cannot be required to provide further medical evidence beyond a fit note
Yes: They must keep your health information confidential, and share it only with people who genuinely need it, such as HR
Yes: They need your permission to ask for a report about your health

A healthcare professional should not give medical information to your employer without your consent. If an employer asks whether a fit note is genuine, the healthcare professional may check the serial number and confirm it was issued, which reveals no medical information.

If your employer decides to stop paying Statutory Sick Pay, they should explain why, and you are entitled to a written statement. You can then ask HMRC for a formal decision on your entitlement.

Fit notes for Universal Credit and ESA

For Universal Credit you must get a fit note if your health condition or disability affects your capability to work for longer than 7 days. You provide details from it in your account. You might not need one if you have moved or are moving from ESA to Universal Credit.

Yes: If your condition affects your capability to work for longer than 28 days, you may need a Work Capability Assessment, and you must continue to get fit notes until you have been sent a decision about it
Yes: When a fit note expires and your health still affects your capability to work, you must get a new one. You get a reminder with the date to report it by
Yes: If you do not report a new fit note you may need to see your work coach to discuss your claimant commitment, and you may be expected to work or look for work

For New Style ESA you are told during your application when to send a fit note. You can send it online with your National Insurance number, using either a digital fit note or a photo or copy of a printed one signed by the healthcare professional, or by post. ESA needs a fit note if you have been unable to work for more than 7 days in a row, and you may need to send fit notes regularly afterwards. See our guides to LCWRA, the Work Capability Assessment and ESA.

Fit notes for stress, mental health and bereavement

A fit note can only cover a medical problem. A healthcare professional cannot give you one for non-medical problems such as problems at home or relationship trouble at work. If a personal issue is making you ill, for example through stress, they may issue one depending on their clinical opinion of how it affects your fitness for work.

Bereavement cannot be written as a diagnosis. If you are too distressed to work, the healthcare professional may write distress due to bereavement, but only where their clinical judgement is that your fitness for work is affected. Otherwise they will explain that they cannot issue one. HMRC's guidance for employers says bereavement is not an incapacity in itself, and Statutory Sick Pay is payable only if your employer accepts the reason. Many employers offer special or compassionate leave instead.

Fit notes in Scotland, Wales and Northern Ireland

The medical evidence regulations behind the current fit note, including the 2022 changes that let nurses, occupational therapists, pharmacists and physiotherapists issue them, extend to England, Wales and Scotland, so the 7 day rule, the list of healthcare professionals and the form are the same in all three.

Northern Ireland is separate. nidirect says you can usually self-certify for 7 days of illness and that beyond that a fit note (statement of fitness for work) is normally required, and that authorised doctors, nurses, physiotherapists, occupational therapists and pharmacists can sign one. nidirect also says you do not need to complete a form to ask your employer for Statutory Sick Pay. For Universal Credit in Northern Ireland, nidirect says you complete a self-certification for up to the first 7 days, and from the eighth day you must provide acceptable medical evidence, normally a fit note.

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Frequently asked questions

How many days can you be off sick without a fit note?

7 calendar days, counting weekends and bank holidays. You can self-certify for that time. You need a fit note if you have been ill for more than 7 days in a row.

What is a fit note?

A fit note, sometimes called a sick note, is a Statement of Fitness for Work, commonly known as a Med 3. A doctor, nurse, occupational therapist, pharmacist or physiotherapist issues it after assessing you. It says you are either not fit for work or may be fit for work, and it is evidence of eligibility for Statutory Sick Pay and for health-related benefits.

Is there an official self-certification form?

Yes. GOV.UK has the SC2 form, which you fill in online and give to your employer. It can be used to self-certify a sick absence or alongside a fit note. Your employer may also accept self-certification verbally, by letter, or on their own similar form.

Can I get a fit note online?

You may be able to request one through the NHS App if your GP surgery offers it, and fit notes can be digital. You still need an assessment by a healthcare professional, which can be face to face, by video call, by phone, or by considering a written report from another healthcare professional.

Can a pharmacy give me a fit note?

Only a pharmacist working at a GP surgery, hospital or clinic. DWP says community pharmacists do not have access to the Med 3 form, so a high-street pharmacy cannot give you one.

Can a GP charge for a fit note?

Not if you have been ill for more than 7 days. For 7 days or less, the healthcare professional might charge a fee, and if your employer asked for the evidence they should cover it.

How long can a GP sign you off for?

Up to 3 months at a time at first. The regulations allow longer only if you have already been advised to stay off work for at least 6 months, when the healthcare professional can enter an indefinite period if you will not be fit for work for the foreseeable future.

Can a fit note be backdated?

Yes. DWP says the fit note may need to include dates earlier than the date it was issued. If your condition has affected you for some time without a previous fit note, the healthcare professional must enter an estimated date from which it did. It cannot be given a future start date.

Do I need a fit note to say I am fit to go back to work?

No. There is no option on the fit note to say you are fit for work, and you can go back at any time, even before your fit note ends, without seeing your healthcare professional.

Can my employer see what is wrong with me?

Your fit note can name your condition, although the healthcare professional can state it less precisely if disclosing it would harm your wellbeing or your position with your employer. Your employer must keep the information confidential and share it only with people who genuinely need it, and needs your permission to ask for a report about your health.

Can I get a fit note for stress, anxiety or depression?

A fit note can only be issued for a medical problem, and only where the healthcare professional considers your fitness for work is impaired. It cannot be issued for non-medical problems such as problems at home or relationship trouble at work, although stress from a personal issue that is making you ill may qualify, depending on the healthcare professional's clinical opinion.

Can I get a fit note for bereavement?

Bereavement cannot be written as a diagnosis on a fit note. If the healthcare professional's clinical judgement is that you are too distressed to work, they may write distress due to bereavement. Otherwise they will explain they cannot issue one, and many employers offer special or compassionate leave.

Do I need a fit note for Universal Credit or ESA?

Yes, if your health condition affects your capability to work for longer than 7 days. For Universal Credit you must keep getting fit notes until you have been sent a decision about a Work Capability Assessment, and you must get a new one when it expires if your health still affects your capability to work.

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Know Your Rights UK. "Fit Notes (Sick Notes): Your Rights and the Rules." Know Your Rights UK, https://www.knowyourrightsuk.com/employment/fit-note