Sick notes and medical reports

Getting a fit note (sick note) when ill health affects your work, or a medical report or letter for an employer, insurer or other organisation.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

A fit note records that ill health affects your work; it is advice to your employer, not a binding order.
You self-certify for the first 7 days off sick and usually only need a fit note after that; NHS notes are free, private ones are charged.
A doctor can only write what is honest and must include relevant information — they cannot tailor a note or report to order.
Reports for employers, insurers or the driving licence authority (DVLA in England, Scotland and Wales; DVA in Northern Ireland) need your consent, and you can usually see a report from your own doctor before it is sent.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypePrivate GP appointment, note or report

AnaestheticNot needed

How long it takesNotes often quick; reports take longer to prepare

Hospital stayOutpatient

Time off workUsually none

When you'll see resultsFit notes often same day; reports usually take days to weeks

On the NHS?NHS fit notes are free after 7 days off sick; reports and private notes are usually charged for

A general guide. Your GP will give you advice for your situation.

Best fit

A fit note supports your sick pay and explains your absence to your employer.

Pause if

Asking for a fit note for the first 7 days off sick, when self-certification is all that is needed.

Main recovery point

A fit note is often issued the same day. The clinician explains the dates and any 'may be fit for work' support suggested.

Good aftercare

Clear explanation of what the note or report says and why.

During or just after the appointment

A fit note is often issued the same day. The clinician explains the dates and any 'may be fit for work' support...

Days to weeks (reports)

A report is prepared after your consent is confirmed and records reviewed; the doctor should offer to show it to...

If you disagree

For a report, you can flag factual errors, attach your own comment, or withdraw consent so it is not released.

Ongoing absence

Fit notes can be extended after review; in the first six months each one can cover up to three months.

Medical line illustration of a clinician and patient discussing a care plan for Sick notes and medical reports. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What are sick notes and medical reports?

A fit note — officially a Statement of Fitness for Work, or Med3 — is the document a clinician gives when ill health affects your ability to work. It records whether you are 'not fit for work' or 'may be fit for work' with support, and can suggest a phased return, altered hours, amended duties or workplace adaptations. It is advice to your employer, not a binding instruction, and your employer decides whether they can offer that support.

You do not need a fit note for the first 7 calendar days off sick — you can self-certify. A fit note is usually needed only after that. It does not have to come from a doctor: as well as GPs and hospital doctors, registered nurses, occupational therapists, pharmacists and physiotherapists can now certify fit notes where it falls within their professional role and they have assessed you. This applies across the whole UK, including Northern Ireland. NHS fit notes are free; a private clinician can issue one but will normally charge.

A medical report is different. It is a written account of your health prepared at the request of an employer, insurer, solicitor or other organisation — for example a report on your sickness absence, a claim, or your ability to do a job. A doctor can write a factual report with your consent, but must be honest, objective and include relevant information rather than only what suits you or the person who asked for it.

This guide explains what a private GP can and cannot sign, and the consent and accuracy rules that protect you when a report leaves the consulting room.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Fit note ('not fit for work')

Confirms that ill health means you should not work for a stated period. Used to support sick pay and to explain absence to your employer.

Fit note ('may be fit for work')

Suggests you could work with support — a phased return, altered hours, amended duties or workplace adaptations. Your employer decides if they can accommodate this.

Self-certification

For the first 7 calendar days of sickness you complete a self-certificate (such as form SC2) and do not need a doctor's note.

Factual medical report

A report based on your records and history, prepared with your consent for an employer, insurer or other body, stating relevant facts about your health.

Supporting letter

A short letter confirming a condition or need — for example for housing, travel, education or benefits — written only where it is honest and you consent to it.

Fit note versus medical report

Feature	Fit note (Med3)	Medical report
Purpose	Explains absence and supports sick pay	Detailed account for a decision or claim
Who asks for it	You, for your employer	Employer, insurer, solicitor, DVLA/DVA
Consent to share	You give it to your employer	Specific consent required first
Detail	Brief	Fuller, with relevant history
Cost	Free on NHS after 7 days	Usually charged for

A fit note is short and goes to your employer; a report is fuller, needs specific consent, and you can usually see one written by your own doctor before it is sent.

Preparing for your appointment

Work out which you actually need — a fit note for sick pay, or a fuller report for a claim or decision.
For a fit note, be ready to explain how your health is affecting your work and what you can and cannot do.
For a report, bring or identify the request letter and exactly what the organisation is asking.
Bring an up-to-date list of medicines, conditions and relevant previous results.
Think about whether you want any 'may be fit for work' support such as reduced hours or amended duties.
Understand that you can give or withhold consent for a report, and ask to see it before it is sent.
Allow time — reports are not usually written on the spot and may need your records.

What happens

For a fit note, the clinician assesses how your health affects your work. This can be in person, by telephone or video, or by considering a written report from another healthcare professional. They decide whether you are 'not fit for work' or 'may be fit for work', for how long, and what support might help, and issue the note. In the first six months of a condition a fit note can only cover up to three months at a time.

For a medical report, the doctor first checks that you have given valid consent. They then review your records and history and write an honest, relevant account answering what has been asked. They should offer to show you the report before it is sent, and you can point out anything you believe is factually wrong, attach your own comment, or withdraw consent so it is not released.

Throughout, the doctor must be truthful and balanced. They cannot leave out relevant information or write something misleading because it would help your case.

Is this appointment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Asking for a fit note for the first 7 days off sick, when self-certification is all that is needed.
Wanting a note or report that is not truthful or that omits relevant information.
Needing an impartial, job-specific opinion, which is occupational health rather than a GP report.
Using a report to settle a dispute that really needs treatment, HR or legal advice.

Delay or rearrange if…

Your consent to a report has not been properly given or explained.
Key records or another clinician's report are not yet available.
Your condition is changing quickly, so any statement would soon be out of date.
You are in crisis or acutely unwell and need care before paperwork.

Alternatives to discuss

Self-certification for short absences.
An occupational health assessment for job- and workplace-specific advice.
Your own NHS GP, where a free fit note or NHS report is appropriate.
HR, a union or legal advice where the issue is really about employment rights.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

A fit note supports your sick pay and explains your absence to your employer.
A 'may be fit for work' note can open the door to a safer, supported return.
A clear, honest report helps an employer or insurer make a fair decision.
Consent and accuracy rules let you check a report from your own doctor before it is shared.
Getting the right document avoids delays with pay, claims or decisions.

Risks & complications

More common

A private fit note or report is usually charged for, unlike an NHS fit note after 7 days off.
A report takes time to prepare and is not issued on the spot.
The note or report may not say what you hoped, because it must be honest.
A 'may be fit for work' note relies on your employer being able to offer support.

Less common

Disagreement about facts in a report, which you can comment on but not rewrite.
The organisation asking for a different or more detailed report than expected.
Delay while the doctor obtains your records or another professional's report.

Rare but serious

A report revealing information you had not expected to be relevant or shared.
A finding that the doctor is required to act on, such as a fitness-to-drive concern.

The main thing to understand is that a doctor cannot write a fit note or report to order. They must be honest and include relevant information, even if it is not what you or the organisation wants. For reports, give consent knowingly, ask to see the report before it is sent, and remember you can usually withhold or withdraw consent if you are unhappy — though that may have consequences for a claim or decision.

Published figures to discuss

This is paperwork following a clinical assessment, not a procedure, so there are no complication rates to quote. What varies is what the note or report can honestly say, which depends on your health, your records and the rules the doctor must follow on consent, honesty and relevance.

Figure	Reported range	How to interpret it	Source / confidence
Report goes beyond medical evidence	Governance risk	Doctors should distinguish facts, clinical opinion and what is outside their knowledge.	GOV.UK — The fit note: guidance for patients and employeesgov.ukSource-linked context
Confidentiality breach	Avoidable with consent	Patients should know what information will be shared and with whom.	Guide sourcesClinical context
Fit note used instead of return-to-work planning	Common	Phased duties, hours, adaptations and review dates often matter more than simply 'fit' or 'unfit'.	Guide sourcesClinical context
Legal/insurance/employment expectation mismatch	Common	Medical reports do not decide employment law or benefits entitlement; they provide medical opinion.	Guide sourcesClinical context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery. 'Afterwards' means when the note or report is issued, who receives it, and what happens if you disagree with what it says.

During or just after the appointment

A fit note is often issued the same day. The clinician explains the dates and any 'may be fit for work' support suggested.

Days to weeks (reports)

A report is prepared after your consent is confirmed and records reviewed; the doctor should offer to show it to you before sending.

If you disagree

For a report, you can flag factual errors, attach your own comment, or withdraw consent so it is not released.

Ongoing absence

Fit notes can be extended after review; in the first six months each one can cover up to three months.

What's normal — and not a worry

Receiving a fit note covering a set period, sometimes with suggested support.
Waiting while a fuller report is written and checked.
Being offered the chance to read a report from your own doctor before it goes out.
Being asked to return for review before a fit note is extended.

Aftercare

Give the fit note to your employer; you do not need to send it to the DWP for Statutory Sick Pay.
Read any report carefully and check the facts before agreeing it can be sent.
Keep copies of notes and reports for your own records.
Diary when a fit note expires so you can arrange review in good time.
If 'may be fit for work' support was suggested, discuss it with your employer.
Raise any factual error in a report with the doctor promptly, before it is relied upon.
Act on any health advice or referral the clinician gave alongside the note.

Before your appointment

Clear idea of whether you need a fit note or a report
The organisation's request letter, if there is one
Up-to-date medicine and condition list
Relevant previous results or reports
Decision on whether you consent to a report being shared
A diary note of any expiry or review date

⚠ Get urgent help if…

Worsening of the condition that is keeping you off work — seek medical help, not just a longer note.
New severe symptoms such as chest pain, breathlessness or sudden weakness — urgent help.
Thoughts of harming yourself — get help straight away. Call 999 or go to A&E if life is at risk. For urgent advice, contact your GP, or use NHS 111 in England, Scotland or Wales; in Northern Ireland, contact your GP out-of-hours service.
Being pressured by an employer or anyone else to obtain a note or report that is untrue.
A health change that affects driving, which you may be legally required to report — to the DVLA in England, Scotland and Wales, or the DVA in Northern Ireland.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your GP gives you.

Results & realistic expectations

A good outcome is an honest, clear document that does its job — a fit note that properly reflects how your health affects your work, or a report that fairly and accurately answers what was asked. For a 'may be fit for work' note, the benefit depends on your employer being able to provide the support suggested.

A fit note cannot force your employer to change your duties, and a report cannot be slanted to guarantee a particular decision. Neither document is a substitute for treatment of the underlying condition, and both reflect only your health at the time they are written.

How long it lasts

A fit note covers a defined period and can be extended after review if you remain unwell; in the first six months of a condition each note can cover up to three months. A report reflects your health at the time it is written, so a new report may be needed if your situation changes or a fresh decision is required.

Related tests, treatments or support

A fit note is often issued during an appointment that also reviews and treats the underlying condition. A medical report may be requested alongside an occupational health assessment when an employer is managing sickness absence — the two have different roles, and the related occupational medicine guides explain the impartial nature of occupational health.

Follow-up & long-term care

If you remain unwell, you return for review before a fit note is extended. For a report, follow-up is usually limited to confirming it was sent and addressing any factual query. The clinician should also arrange appropriate follow-up or referral for the underlying condition itself.

Arrange review before a fit note expires if you are still unwell.
Keep copies of all notes and reports for future reference.
Tell the relevant authority if your health changes in a way you are required to report — for driving, that is the DVLA in England, Scotland and Wales, or the DVA in Northern Ireland.

Repeat, follow-on and what comes next

Fit notes are routinely extended after review while you remain unwell.
A report can be reissued if facts change, but cannot simply be rewritten to a preferred conclusion.
You can attach your own comments to a report you disagree with, or withhold consent for release.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

Clear explanation of what the note or report says and why.
An offer to see a report before it is sent, with a route to flag factual errors.
Proper follow-up or referral for the underlying condition, not just paperwork.
A named contact for queries about the note or report.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether you need a brief fit note or a fuller report.
How long it takes to assess you and, for reports, to review your records.
Whether your medical records or another professional's report must be obtained.
The complexity of what the organisation has asked the report to cover.
Whether you are seen privately rather than by your NHS GP.
Whether follow-up reviews or extensions are needed.

Make sure your written quote includes

The fee for a fit note and, separately, for a written report.
What the report will cover and how long it will take.
Whether reviewing your records is included.
That you will be offered the chance to see a report before it is sent.
How the note or report will be delivered, and to whom.
What happens, and any cost, if a further note, extension or amended report is needed.

On the NHS? NHS fit notes are free once you have been off sick for more than 7 days; private fit notes, supporting letters and medical reports are usually charged for and may not be an NHS service.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the GP is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the GP who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

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Questions to ask your medical professional

Take this to your consultation. A good GP will welcome every one of these.

Do I need a fit note, or a fuller report, for what I am trying to do?
If you write a report, what exactly will it cover, and can I see it before it is sent?
What does giving or withholding my consent mean for my claim or decision?
Could a 'may be fit for work' note with adjustments help me return sooner?
How long will this fit note last, and when should I come back for review?
Is there anything in my records you would be obliged to include that I should know about?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the GP who carries out my appointment, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this appointment not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Do I need a sick note for a few days off?

No. For the first 7 calendar days off sick you can self-certify and do not need a doctor's note. A fit note is usually only needed after that.

Is a fit note free?

An NHS fit note is free once you have been off sick for more than 7 days. A private doctor can issue a fit note but will normally charge, and reports are charged for too.

Who can issue a fit note?

It does not have to be a doctor. As well as GPs and hospital doctors, registered nurses, occupational therapists, pharmacists and physiotherapists can certify fit notes, as long as it falls within their professional role and they have assessed how your health affects your work. This applies throughout the UK, including Northern Ireland.

Can a private GP issue a fit note?

Yes. A suitably trained, registered clinician working privately can issue a fit note after assessing how your health affects your work, though there is usually a fee.

Does my employer have to follow the fit note?

A fit note is advice, not a binding instruction. 'May be fit for work' suggestions such as reduced hours are for your employer to consider; if they cannot accommodate them, the note is treated as 'not fit for work'.

Can I see a report before it goes to my employer or insurer?

Usually yes. Where the report is written by a doctor who has been responsible for your care, you generally have the right to see it first, to comment on anything factually wrong, and to withhold consent for it to be sent.

Can the doctor leave out things that might count against me?

No. A report must be honest and include relevant information. A doctor cannot omit relevant facts or write something misleading to help your case — doing so would breach their professional duties.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: GOV.UK — The fit note: guidance for patients and employees GOV.UK — Who can issue fit notes GMC — Disclosing information for employment and insurance GOV.UK — Taking sick leave (Statutory Sick Pay and fit notes) GOV.UK — Telling DVLA about a medical condition Health NI — More healthcare professionals can certify fit notes (Northern Ireland) nidirect — Urgent and emergency care services (Northern Ireland) nidirect — GP out-of-hours service (Northern Ireland) GOV.UK — Assessing fitness to drive (DVLA) nidirect — How to tell DVA about a driver medical condition (Northern Ireland)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.