Self certificate form (CCU67a)

Date published: 10 January 2022

From 17 December 2021 modified regulations increase the period that an employee is not required to provide medical information in respect of any spell of incapacity for work from 7 to 28 days. This took affect for any absence commencing from the 17 December 2021 or later up to and including the 26 January 2022.  The new regulations also apply to spells of sickness which commenced prior to the regulations coming into force but which have not lasted more than seven days on that date e.g. 11 December 2021  (as the requirement to provide medical evidence will not have arisen at that point). Any absence beyond 27 January 2022 will revert to the normal procedure requirements e.g. any continuous absence of more than 7 calendar days will again require a Statement of Fitness for Work certificate. In response to the rapid spread of the Omicron variant the regulations only apply for a short time to provide the necessary support to medical professionals. 

This form (CCU67a) should be used to certify illnesses of between 1 and 28 calander days.

This form (CCU67) should be used to certify illnesses of between 1 and 7 calendar days.

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