Sickness and sick pay: (02) Statement of fitness for work (fit note) (form)

When to use this statement of fitness for work form

This is a sample version of the statement of fitness for work (or "fit note") that a doctor can give to an employee as evidence of whether or not he or she is able to go to work. It replaces the sick note from 6 April 2010. Employers can use the sample form to familiarise themselves with the format of the fit note.

Related documents

Letter informing an employee who has a statement of fitness for work saying that he or she can return to light duties that there is no light work to do

Form wording

Statement of fitness for work: for social security or statutory sick pay (PDF format, 76K) (on the Department for Work and Pensions website).