How to get a fit note: the step-by-step UK guide

If you are in crisis or feel unsafe, please call 999 or go to A&E. For urgent mental health support, call NHS 111 and select the mental health option. Samaritans (116 123, free, 24/7) and Shout (text 85258) are always available.

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To get a fit note, contact the healthcare professional treating you, usually your GP surgery, by phone or through their online form, and they will assess you in a phone, video or in-person conversation and issue the note if your health is affecting your ability to work. You only need one once you have been off sick for more than seven days in a row, including weekends and bank holidays, and there is no charge at that point.

This guide walks through the practical journey: when you actually need a fit note, the ways to ask for one, what the conversation involves, and what happens after it is issued. It deliberately stays on the getting, because the surrounding stages have their own guides. If you want to understand the document itself, what a fit note is covers that, and if you are further along and thinking about going back gradually, how a phased return to work actually works covers the return. Everything here is drawn from NHS and GOV.UK guidance, and the questions a fit note cannot answer, like pay and your rights while off, belong with ACAS or Citizens Advice rather than a health guide like this one.

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Do I need a fit note for the first 7 days off sick?

No. If you are off work ill for seven calendar days or less, including weekends and bank holidays, you do not need a fit note at all, because you can self-certify that period yourself.

Self-certification usually just means telling your employer you are unwell in whatever way they ask, and GOV.UK provides an employee's statement of sickness (the SC2 form) that some employers use for statutory sick pay purposes. The seven days are counted in calendar days, not working days, which catches a lot of people out: if you go off on a Wednesday, the weekend counts towards the seven. It is only once your absence passes seven days that a fit note comes into the picture, and that is the point at which it stops costing anything.

One boundary worth knowing before you ask: GOV.UK is clear that a fit note can only be issued for medical problems. A healthcare professional cannot give you one for non-medical difficulties, such as problems at home, although they may be able to point you towards other sources of support. Mental health conditions are medical, so stress, anxiety and low mood all count in exactly the same way as physical health.

Step by step: how to get a fit note

The route is simpler than most people expect, and it starts with whoever is treating you.

Contact the healthcare professional supporting your care. For most people that means their GP surgery. Phone them, or use the secure online form on the surgery's website, which the NHS describes as a way to tell your surgery what is wrong and get a response about what happens next, usually within one working day. You may also be able to reach the form through the NHS App. If forms are not your thing, calling or visiting the surgery works just as well.

Know that it does not have to be a doctor. Since a 2022 change, the NHS lists five types of healthcare professional who can provide fit notes: doctors, nurses, pharmacists at GP surgeries, hospitals and clinics, physiotherapists and occupational therapists. If a physiotherapist is already treating you, they may be able to issue the note themselves, which saves a separate GP appointment.

If you are in hospital, ask before you leave. GOV.UK says the healthcare professional responsible for your discharge should be the one who issues the fit note where possible, and that you should discuss it with them before you are discharged, rather than being sent back to your GP purely to get the paperwork.

Have the work conversation honestly. The assessment is a conversation about how your health affects what you can do at work, not a test to pass. GOV.UK notes that if the healthcare professional does not ask how your health affects your work, you should raise it yourself.

Can I get a fit note online or without seeing a doctor?

Often, yes. The assessment behind a fit note does not have to happen face to face: the NHS says the healthcare professional will talk with you in person or on the phone, and GOV.UK adds that the assessment can also happen by video call or through a written report from another healthcare professional.

The note itself can be digital too. Since the 2022 changes replaced the ink signature with the printed name and profession of the issuer, fit notes can be handwritten or computer-generated, and printed or shared with you digitally where the surgery's IT system supports it. So the realistic modern journey is often: online form or phone call to the surgery, a telephone conversation with a clinician, and a fit note arriving digitally, without you setting foot in the building. What does not exist is a legitimate way to buy an NHS fit note from a website without any assessment, because the note is, by definition, a healthcare professional's clinical judgement about you.

A valid fit note must include the issuer's name, their profession and the address of the medical practice. Private healthcare professionals who are not treating NHS patients may produce other forms of medical evidence, such as a private medical certificate, which GOV.UK says employers may accept in the same way, subject to their agreement.

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What the note will say, and what it costs

The assessment ends in one of two outcomes on the form: "not fit for work", or "may be fit for work" with support from your employer, such as a phased return, altered hours, amended duties or workplace adaptations. A healthcare professional cannot issue a note saying you are fit for work, because if you are fit for work you do not need the document. If your employer cannot put the suggested support in place, both the NHS and GOV.UK say the note is treated as though it says "not fit for work", and you do not need to go back for a new one.

On cost, the position is simple. You do not pay for a fit note if you have been off sick for more than seven days. If your employer wants medical evidence for the first seven days of an absence, a healthcare professional may charge a fee for providing it, and that cost should be covered by the employer, not you.

The note belongs to you. Your employer can take a copy for their records, but you keep the original, and a duplicate can only be issued if the original has been lost. You can also go back to work as soon as you feel able to, with your employer's agreement, even before the note's end date, and you do not need to see a healthcare professional again to do so.

If the reason is your mental health

A large part of the reason people search for fit notes is not a broken ankle, it is that work has become unmanageable, and asking a stranger to sign you off for that can feel harder than asking for anything physical. It should not. GOV.UK's own patient guidance includes a mental health case study, and the process above is identical whatever the condition.

If that is where you are, the fuller guide to getting a sick note for work for your mental health walks through the appointment itself and what to say, and how long you can be signed off with stress covers the longer-term picture. Support during the weeks a fit note covers does not have to mean committing to weekly therapy either. Wobble's therapists work to the Wobble response framework, a structured framework built for short, practical, single-response support, and when Wobble was tested with real people, 96% said they felt better after a single video. One clear step at a time tends to suit exactly the stretch a fit note covers.

When to see your GP

If you are reading this because you are unsure whether you are unwell enough to justify asking, that uncertainty is itself worth taking to your GP. Book an appointment if you have felt unable to cope with work most days for a few weeks or more, if your sleep, mood or relationships are being affected, if you are leaning on alcohol or other substances to get through, or if you have been pushing on and nothing is improving. You do not need to have decided you want time off before you go, and asking about a fit note is a normal, everyday part of what GP surgeries do.

In England you can also refer yourself to NHS Talking Therapies at nhs.uk/talk without going through your GP, though waits vary widely. In Scotland, Wales and Northern Ireland the GP route is the standard one. For urgent mental health support, NHS 111 has a 24/7 mental health option, Samaritans (116 123) are free to call day or night, and Shout (text 85258) is there if calling feels like too much.

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Quick summary

You only need a fit note once you have been off sick for more than seven calendar days, including weekends and bank holidays, and you self-certify anything shorter. To get one, contact the healthcare professional treating you, usually via your GP surgery's phone line or online form, and a doctor, nurse, pharmacist, physiotherapist or occupational therapist can issue it after a conversation in person, by phone or by video. The note will say either "not fit for work" or "may be fit for work" with support, there is no charge once you are past seven days, it belongs to you, and you can return to work before it runs out without being reassessed. Fit notes are only issued for medical problems, and mental health counts in exactly the same way as physical health. For pay and rights while you are off, ACAS and Citizens Advice are the right places to go.

For the document itself, see what a fit note is. For the mental health journey around it, see getting a sick note for work.

Sources and further reading

• NHS: Getting a fit note (nhs.uk)
• NHS: Using an online form to contact your GP surgery (nhs.uk)
• GOV.UK: The fit note, guidance for patients and employees (gov.uk)
• GOV.UK: Statutory Sick Pay, employee's statement of sickness (SC2) (gov.uk)
• NHS Talking Therapies self-referral (England): nhs.uk/talk
• ACAS: acas.org.uk
• Citizens Advice: citizensadvice.org.uk
• Samaritans: 116 123 (samaritans.org)
• Shout: text 85258 (giveusashout.org)

This article is for information only and does not replace advice from a qualified medical professional. If your health is affecting your daily life, please speak to your GP or contact NHS 111. If you are in crisis, please call 999 or go to A&E.