This form should be completed whenever you are absent from work due to sickness. If your absence was more than 7 calendar days you must submit a medical statement/Doctor note from your doctor along with this form.  

Guidance Notes for Employees

1. On the first day you are absent you must notify your supervisor as soon as possible stating the nature and probable duration of your illness. This will normally be by a telephone call from yourself or someone phoning in on your behalf. Written notification is also acceptable as long as it is posted on the first day of absence.
2. If you are away for more than 3 days you must, on your 4th day of absence notify your supervisor of the reason for your continued absence. Again. Notification can be by phone or letter. Alternatively, once you have been away for 4 days you may be sent a self-certificate form to complete and return immediately. If you think it will be difficult for you to notify by phone on the 4th day of absence you can ask for a self-certificate form to be sent to you so you can complete and return this on your 4th day of absences. You may also be able to collect a self –certificate form from your place of work or departmental administrative office.
3. If you are away sick for more than 7 calendar days you must obtain a sick certificate from your doctor on the 8th day of absence and forward this to your employing department. (If, during the first 7 calendar days of your absence your Doctor gives you a sick certificate, this should be sent immediately to your employing Department).
4. You will also be asked to complete a self-certificate form wherein special circumstances you are required to submit statements to support absences of 3 days or less (of which you will have been informed).
5. If you are unable to complete the section of the form which details the reason for your absence without giving detailed medical information which you would wish to be treated as medically confidential, please indicate this in the space overleaf and complete and sign the rest of the form. Your employing Department may wish to arrange for you to contact the Council'’ medical Advisor (or Occupational Health Nurse as appropriate). If you have a doctors certificate covering any part of the current illness, it will suffice to enter "see attached doctor'’ certificate"

Please note, failure to fulfil any of the above requirements of the self-certification procedure may result in non-payment, or a delay in payment for the period involved.