Ask your employer for Statutory Sick Pay
You may use this form to ask your employer for Statutory Sick Pay (SSP). You must have been off work due to sickness for more than 3 days in a row to be eligible.
If you are off work for more than 7 days in a row due to sickness, you must also give your employer a fit note (sometimes known as a sick note). You should count non-working days, including weekends and bank holidays. You can find out more about fit notes on the fit note guidance page.
You can find out how much you can receive and eligibility on the Statutory Sick Pay guidance page.
Before you start
You should check your employment contract to ensure you are following any agreed sickness procedure. Your employer may give you extra sick pay on top of Statutory Sick Pay if you do this.
Once you have completed the form, you will need to download it and send it to your employer. If you are sending it in the post, you will need a printer.Start now