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  • Self Certification Form Printable

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CONFIDENTIAL Sickness Self-Certification Form EMPLOYEE DETAILS Full Name Department Payroll No. Job Title from your payslip DATES OF SICKNESS First full day of sickness Last full day of sickness Date returned to work Please state briefly why you were off work sick Was this as a result of an accident/injury at work Yes No Declaration to be completed by the member of staff reporting the absence I confirm that I was unfit for work due to sickness in the period stated above and that the information I have given is correct and complete. I understand that making a false statement may result in disciplinary action being taken and sick pay being terminated* I understand that this information will be used to record my absence and calculate my entitlement to pay. Date 19/10/11 FOR DEPARTMENTAL USE ONLY Comments Return to work interview held Opendoor code Date entered on system REASONS FOR ABSENCE CODE LIST ALL Allergy DENT Dental EYES Eyes HBP Heart Blood Pressure HMH Headache/Migraine/Head pain....

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How to fill out the Self Certification Form Printable online

Filling out the Self Certification Form Printable is an essential process for documenting your absence due to sickness. This guide provides clear and supportive instructions to ensure you can complete the form accurately and efficiently.

Follow the steps to successfully complete the Self Certification Form Printable.

  1. Click the ‘Get Form’ button to obtain the Self Certification Form Printable and open it in the document editor.
  2. Fill in your personal details in the Employee Details section. This includes entering your full name, department, payroll number, and job title as it appears on your payslip.
  3. In the Dates of Sickness section, accurately state the first full day of sickness, the last full day of sickness, and the date you returned to work. Additionally, provide a brief explanation of the reason for your absence.
  4. Indicate whether your sickness was a result of an accident or injury at work by selecting 'Yes' or 'No'.
  5. Complete the declaration statement affirming that you were unfit for work during the specified period. Confirm that the information provided is correct and complete by signing and dating the form.
  6. If applicable, refer to the Departmental Use Only section for any comments or additional notes. This area may contain helpful information for the department managing your absence.
  7. Review the entire form for accuracy and completeness. Finally, save your changes, download, print, or share the completed Self Certification Form Printable as needed.

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Many employers have their own self-certification forms. If your employer doesn't have its own form you can download this Self Certification Form (PDF). Please print it, fill it in and hand it in to your employer. You do not need to see a Doctor.

Many employers have their own self-certification forms. If your employer doesn't have its own form you can download this Self Certification Form (PDF). Please print it, fill it in and hand it in to your employer. You do not need to see a Doctor.

7 days off sick or lessIf 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. This is called self-certification.

If you have an illness lasting seven days or less you do not require a doctor's sickness certificate. Your employer may require you to complete a self-certification form called an SC2 which is available from the HMRC website or you can click on the link below to download a form.

If you are off work for less than seven days, you are responsible for your own self-certification on form SC1 (available from reception or any post office).

Tell your employer straight away that you're sick and can't work. Let your employer know what the first day of your illness was, even if it was a non-working day. Confirm your illness in writing (this is called 'self-certification'). You'll need to do this within 7 days of telling your employer you're sick.

If you are off work for less than seven days, you are responsible for your own self-certification on form SC1 (available from reception or any post office).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232