Illness Certificates

If you are unable to work due to illness, you may be eligible for Illness Benefit from the Department of Employment Affairs and Social Protection (DEASP). Certificate of Incapacity for Work To apply for Illness Benefit, you will need a Certificate of Incapacity for Work, which must be issued by a GP. Your GP can submit this certificate electronically through a secure online system. In some cases, a single certificate may cover the full duration of your illness. If required, you may need to return for further review and additional certificates. To open your claim, you can apply online here. Employer Sick Leave Certificate Your employer may also require a separate medical certificate (commonly referred to as a sick note or work cert). This is typically needed if you are absent for more than 2 or 3 consecutive days. This certificate must also be obtained from a GP. Extending Your Certificate If you need to extend your Illness Benefit certificate or medical certificate, you may submit the form below. We will contact you if a further GP review is necessary.

Illness Certificates

First name

Last name

Phone

Birthday

Day

Month

Year

Certificate Start Date

Certificate End Date

Full Address

Reason for cert

Do you require the cert for:

Work

College

School

I confirm that I am requesting an extension of an existing cert. (Please make an appointment to see a GP if you

have a new medical issue.)

I consent to this message being sent electronically to the practice. I have checked that the email address and

phone number supplied are correct and consent to receiving medical information via email or text.

By submitting this form you will be sending personal/sensitive information about yourself across the Internet. Please read our privacy statement to discover how we protect and manage your submitted data. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of contacting the practice.