Please fill in this form and return it to

Please fill in this form and return it to

Please fill in this form and return it to

Please fill in this form and return it to

Please fill in this form and return it to

Please fill in this form and return it to

Please fill in this form and return it to

Please fill in this form and return it to

Please fill in this from and return it to

If you’re off work sick for 7 days or less, your employer should not ask for medical evidence that you’ve been ill. Instead, they can ask you to confirm that you’ve been ill. You can do this by filling in a form yourself when you return to work. We call this self-certification.