Sickiemate
Menu
Medical Certificate
Online Prescription
Telehealth Consultation
Consult Now
Basic Information
Please take care as the following name and address will appear on your certificate
(Required)
First
Last
Hidden
Number
Please enter a number from
1
to
10000
.
Gender
Select
Male
Female
Date
MM slash DD slash YYYY
Hidden
Men Value
Hidden
Female Value
Hidden
His Value
Hidden
Her Value
Work/Study
Work
Study
Email
Phone
Current Date*
MM slash DD slash YYYY
Leave Date*
MM slash DD slash YYYY
Are you feeling unwell/unfit for work today due to a minor or ailment/illness or injury?*
(Required)
Yes
Please choose from one of the following symptoms?*
Common Cold or Flu
Headache or migraine (same as before)
Low back pain (due to muscle strain)
Period Pain (same as before)
Dental Pain
Cough
Sneezing or runny nose
Food poisoning or stomach upset
Hay fever or allergies
Other
Minor injury
Consent*
By checking this box, you confirm that you have read and agree to the information in the section above and accept our Privacy Policy. You can access the full terms and conditions and privacy policy here. You also agree to have truthfully answered all questions in the questionnaire.
YOUR AGREEMENT By agreeing to this release form, you agree to be bound by and comply with the Terms and Conditions. If you do not agree to these Terms and Conditions, please do not tick the box. By using our service you agree to the certificate dated for today's date.
PLEASE NOTE
• Certificates are issued by Pharmacists, not as a medical practitioner/doctor and issued from the date that the consultation took place
• The consultation is not intended to replace medical treatment, opinion or diagnosis
• You agree that if your illness/injury persists or worsens, you will seek medical attention/see a doctor
• Pharmacists can only issue a certificate (Fair Work Act 2009) if in his/her professional opinion you are required to be absent from work/university due to personal minor illness/injury OR the need to care for a member of your family/household who is ill/injured
• Pharmacists can only issue certificates in relation to illness/injury that they are professionally qualified to
assess
Ask your employer FIRST if a certificate issued by a pharmacist will be satisfactory.
