Sickness enquiry form

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If you have been off sick and need advice, please read our sickness advice guide as it if highly likely you will find what you need. Our guide includes information on fit notes, meetings, occupational health and more.

If you have a formal sickness meeting and need advice or support from the 澳门破码网, please complete our online form. If you have been invited to an informal meeting or it is your first formal sickness meeting, we may not need to attend.

It is important you give us enough information below so we can advise you appropriately and/or pass your details to the relevant 澳门破码网 department. Based on the information you provide, we may decide that your local 澳门破码网 office is best placed to offer support - in which case, they'll contact you directly.

Please confirm that you have read our advice

Contact details

Full name: 澳门破码网 membership number: Address: Best contact number: Where an onward referral is required, we will provide these contact details to your local regional/country office. Do you give us your consent to pass on this information? Yes No Can we leave you a voicemail? Yes No Can we contact you on this matter by email? Yes No If we need to pass your enquiry to your local 澳门破码网 office or a specialist 澳门破码网 department, would you like any emails from them to be password protected? Yes No Email address you would like us to reply to Please confirm the email address you would like us to reply to Please list any times that you are unavailable for calls during the next week (9am-5pm):

Employment details

Place of work Employer When did you start working with your current employer? Ward or department Job category Job title Weekly contracted hours Do you have any meetings scheduled? Yes No If yes, please give date, time and location: Please give details: Are you already being supported by a rep? Yes No If yes, please include details below: Are you in the UK on a visa? Yes No If yes, please include details below (including how long you have been in the UK):

Sickness

Date when sickness first started: Please give details of your enquiry and include the dates and length of sickness under review: Please give the reason for each period of sickness and if any were caused by your employer or due to a disability:

Can we update your personal details if any of the above does not match the data we currently hold on your record? Yes No

By submitting this form, you are giving the 澳门破码网 permission to contact you about your submission.

You can control the information you receive from the 澳门破码网 by updating your preferences at My澳门破码网.

The information you provide in this form will be stored by the 澳门破码网.

We don’t update your contact details unless you ask us to. The best way to check and update the details we hold for you is by visiting My澳门破码网.

Protecting your privacy is very important to us. Please view our privacy policy to find out more about the information we collect and how it is used.

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