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    1. Dr. Sudam Prabhu assessed Mr. Max Francis Swinscoe and determined he was not fit for work from December 12, 2022 to December 19, 2022 due to a throat infection. 2. The doctor advised that Mr. Swinscoe may benefit from a phased return to work, amended duties, or workplace adaptations with his employer's agreement. 3. Dr. Prabhu provided the fitness note to excuse Mr. Swinscoe from work for one week and indicated he would not need to reassess Mr. Swinscoe's fitness at the end of that period.

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    1. Dr. Sudam Prabhu assessed Mr. Max Francis Swinscoe and determined he was not fit for work from December 12, 2022 to December 19, 2022 due to a throat infection. 2. The doctor advised that Mr. Swinscoe may benefit from a phased return to work, amended duties, or workplace adaptations with his employer's agreement. 3. Dr. Prabhu provided the fitness note to excuse Mr. Swinscoe from work for one week and indicated he would not need to reassess Mr. Swinscoe's fitness at the end of that period.

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    8 views1 page

    Documentation Image

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    1. Dr. Sudam Prabhu assessed Mr. Max Francis Swinscoe and determined he was not fit for work from December 12, 2022 to December 19, 2022 due to a throat infection. 2. The doctor advised that Mr. Swinscoe may benefit from a phased return to work, amended duties, or workplace adaptations with his employer's agreement. 3. Dr. Prabhu provided the fitness note to excuse Mr. Swinscoe from work for one week and indicated he would not need to reassess Mr. Swinscoe's fitness at the end of that period.

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    StatementofFitnessforWork Whatyouradvicemeans
    ForsocialsecurityorStatutorySickPay
    'Youarenotfitforwork'
    Patient'sname MrSwinscoe Yourhealthconditionmeansthatyoumaynotbeabletoworkforthe
    periodshown.Youcangobacktoworkassoonasyoufeelabletoand,with
    Iassessedyourcaseon:12/12/2022 youremployer'sagreement,thismaybebeforeyourfitnoterunsout.
    and,becauseofthe throatinfection 'Youmaybefitforwork'
    followingcondition(s): Youcouldgobacktoworkwiththesupportofyouremployer.Sometimesyour
    employercannotgiveyouthesupportyouneedandifthishappensyour
    employerwilltreatthisformasthoughyouare'notfitforwork'.Youdonot
    needtogetanotheroftheseforms.
    Iadviseyouthat: youarenotfitforwork.
    Formoreinformationpleasevisitwww.gov.ukandtype'fitnoteguidance
    youmay-be-itt-for-work-taking-account-ef
    forpatientsandemployees'intothesearchfield.Fitnoteguidancefor
    thefollowingadvices
    employersisalsoavailable.
    Ifavailable,andwithyouremployer'sagreement,youmaybenefitfrom:
    aphasedreturntowork. amendedduties. Datafrompage1ofthisformmaybecollectedtolearnaboutnational
    patternsofsicknessabsence.Individualswillnotbeidentified.Findout
    giered-hours- workolace-odaptations
    moreatwww.gov.uk/dwp/fit-note-data
    Comments,includingfunctionaleffectsofyourcondition(s):

    FillintheYourdetailssection.Youcanasksomeonetodothisforyouif
    youcannotfillinyourdetailsyourself.
    Yourdetails-PleaseuseBLOCKCAPITALS

    Surname [MrSwinscoe

    Othernames MaxFrancis

    Address 86HaddonCrescent
    Beeston
    Thiswillbethecasefor8days Nottingham PostcodeNG95JR
    orfrom12/12/2022 to19/12/2022 Dateofbirth 15/12/1985 Mobile07738708788
    Iwill/willnotneedtoassessyourfitnessforworkagainattheendofthisperiod. NInumber
    Pleasedeleteasapplicable)

    Issuer'sname DrSudamPrabhu Whatyouneedtodonow


    Issuer'sprofession Doctor
    •Ifyouareemployed:Pleaseshowthisformtoyouremployer.YoucouldgetStatutory
    SickPay(SSP)whichispaidbyyouremployer.IfyouremployercannotpayyouSSP
    Dateofstatement 12/12/2022 theywillgiveyouformSSP1toclaimbenefits.
    Issuer'saddress •Ifyouareself-employed:Youcouldclaimbenefits.
    TheManorSurgery(Nottingham) •Ifyouarealreadyclaimingbenefits:Pleasesendthisformtotheofficedealingwith
    MiddleStreet
    yourclaim.
    Nottingham
    NG91GATel:01159076960 •Ifyouneedtomakeaclaimtobenefits:Visitwww.gov.uk/browse/benefitsorphone
    08003285644(8amto6pmMondaytoFriday).Textphoneuserscall08003281344.
    UniqueID:Med304/22 CBB9B810-7A4D-11ED-AD54-69B754E8AEC

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