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Self-certification form for sickness or incapacity absence

This form is the ideal way to record the details of sickness absence or absence due to incapacity when the employee is absent for less than 7 days and does not have a fit note from a medical professional.

We recommend that all employees are required to complete the form after every period of absence due to sickness or incapacity.

£15.00 + VAT


When an employee is absent from work for less than 7 days and/or they do not have a fit note from their doctor it is important that you still obtain information about the reason for their absence and causes of this.

We therefore strongly recommend that all employees are asked to complete a self-certification form on their return after any period of leave for sickness or incapacity.

The format of the form covers the key questions and information needed to assess risk and consider if reasonable adjustments may be needed.

There is also a space on the form for managers to record their follow up discussion with employees. We strongly recommend that all absence is followed with a chat form a line manager or supervisor. It is essential for effectively managing sickness absence.

Once downloaded the form can be saved and used as many times as you wish.



If you would like help with managing sickness absence or training for your managers on how to handle conversations with employees when they return to work we can arrange this for you, normally for an agreed fixed fee. Please contact us for a free no obligation chat and quote on 01983 897003. Alternatively, if you prefer to email you can email



This document has been produced for the purpose of information only. It should not be substituted for obtaining legal advice that is specific to the circumstances. The content is also valid as at the 5th February 2024. Employment law changes regularly and therefore you should ensure that you check the up-to-date position on a regular basis.

© Copyright 2024. Real Employment Law Advice.


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