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Self certification form

Free Self-Certification Form Template & Example

Self certification form
Updated on
02
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15
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2025
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Self Declaration Form, Personal Certification, Declaration of Health
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Free Self-Certification Form Template & Example
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Have you ever wondered how to document your sick leave officially? A self-certification form is your go-to tool for absences lasting less than eight days. It's a simple yet essential document for both employees and employers to manage short-term sickness efficiently.

In this article, you'll learn about the key elements of a self-certification form and how to use it effectively.

Table of Contents

What Is a Self-Certification Form?

A self-certification form is a tool that helps you communicate your sick leave to your employer without needing a doctor's note. It's particularly handy when you're ill for a short period, typically seven days or less. You fill it out yourself, providing the necessary details about your sickness.

Many companies offer their own versions of this form, or you can use an SC2 form.

This can be used if you're off work for three days or more due to sickness, even including non-working days. It simplifies the process of notifying your workplace about your health status.

Self-certification is often required by employers to track absences and ensure the process is transparent.

While a doctor's note isn’t necessary in these cases, it might still be requested by some employers who follow stricter protocols.

If your illness stretches beyond the initial self-certification period, your employer can ask for medical evidence. Some employers might charge for a doctor's note during this extended period, so it’s good to check their policy.

Completing the self-certification involves listing basic details like your name, illness dates, and a brief explanation if needed.

This form helps facilitate communication between you and your employer, making it easier to manage short-term absences.

When Is a Self-Certification Form Needed?

A self-certification form is something you fill out when you're off sick for up to seven days. It's your way of telling your employer about your sickness absence without needing a doctor's note. It's particularly helpful when you're too ill to work but don't need a healthcare professional’s visit.

You'll typically hand in a self-certification form when you need to claim Statutory Sick Pay (SSP) for short-term sick leave. However, if your absence stretches beyond seven calendar days, you might need to see a doctor for a fit note.

A self-certification form is crucial in record-keeping for pay calculations and sick leave justification. Some employers may have their own forms or processes, while others might rely on standard forms like the SC2 form.

Your self-certification form will include the duration and reason for your absence. Providing this form ensures you meet your employment terms, making sick pay claims seamless.

Even when absent for just a few days, including non-working days, like weekends, you should still give your employer this form.

Providing self-certification is all about keeping everything transparent and ensuring your employer is aware of all your sick days, even if they fall outside your typical work schedule.

How to Write a Self-Certification Form

Creating a self-certification form is a straightforward process, and it’s all about capturing the right details. Here are the steps to take when self-certificating.

Step 1: Gather Basic Information

Begin by collecting your essential details. This includes your name, address, phone number, and National Insurance number. You’ll also need to ensure you have your employer’s details, such as their name and address.

Make sure all this information is clearly stated at the top of the self-certification form.

Step 2: State the Sickness Period

Clearly mention the start and end date of your illness or absence. These dates help both you and your employer track the period of your sick leave.

It's a good idea to include any non-working days if they apply.

Step 3: Describe the Reason for Your Absence

Describe why you were unable to work, keeping it concise and straightforward.

Mention if any reasonable adjustments, like changes to your work environment, could facilitate your return.

Also, make a note if you consulted any professionals, like an occupational therapist.

Step 4: Include Employment Details

You should list your payroll number if your company uses one. This helps in linking your form to your payroll records, ensuring any payments, such as Statutory Sick Pay, are processed correctly.

Step 5: Signature and Date

At the end of the form, there’s a space for your signature and the date. Signing and dating your form confirms the accuracy of the information provided.

By following these simple steps, you’re set to create a functional and effective self-certification form.

Frequently Asked Questions

Who needs a self-certification form?
What if an employee is sick for more than 7 days?
What details of the sickness should an employee provide on a self-certification form?
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