How to get a sick note (Baixa Médica) from a doctor for your employer

You wake up on a Tuesday in Lisbon with a fever, and your manager is already asking for “a baixa.” You have no family doctor, your Portuguese is shaky, and you are not sure the system even knows you exist. This guide explains how to get a sick note in Portugal, which route fits your situation, and how to get the paperwork to your employer without drama.

What a Baixa Médica Actually Is in Portugal

The Official Name Behind the Slang

Everyone at work calls it “a baixa,” but the official document is the Certificado de Incapacidade Temporária para o Trabalho, usually shortened to CIT. A doctor uses it to certify that you are temporarily unable to work. It does two jobs. It justifies your absence to your employer, and it is the document Segurança Social, the Social Security system, uses to assess whether you qualify for sickness benefit.

The first time I needed one, I walked into my local Centro de Saúde expecting a doctor to hand me a signed slip of paper. Instead, the doctor typed for a minute, told me it was “no sistema,” and sent me home. That is how it works now. The CIT is issued electronically and goes directly to Segurança Social. You do not carry a stamped form to an office, but you are still responsible for telling your employer.

If you want to understand how sickness benefit sits alongside other types of leave, see Sick Leave (Baixa) and Maternity/Paternity Leave Benefits in Portugal. Your wider rights as an employee are covered in Employment Rights in Portugal: Contracts, Leave, and Labor Laws.

The Two Numbers You Need Before You Get Sick

This is where foreigners hit trouble. Two identifiers have to be in place for a sick note to work properly:

• Número de Utente: your SNS user number. It identifies you to the public health system, and an SNS doctor needs it to issue the certificate.
• NISS: your Social Security number. The CIT is linked to your NISS so that Segurança Social can connect your absence to your contribution record.

Picture Priya, a software tester who moved to Porto three months ago. Her employer registered her with Social Security, so she has a NISS. She never got around to the health centre, though, so she has no utente number. When she comes down with flu, the SNS 24 line can triage her, but the paperwork stalls until her registration is sorted. Do not end up like Priya. Register now, while you are healthy, using Registering with the Centro de Saúde: Getting Your SNS Número de Utente. If your NISS is still pending, see Getting your NISS online: Step-by-step guide for new foreign workers.

Who Can Issue the Certificate

Several types of doctor can issue a CIT:

• Your family doctor at the health centre.
• A doctor at a public hospital emergency department.
• Doctors at many private hospitals and clinics, which can also issue it through the electronic system.

If you are going private, ask at reception before your consultation whether the doctor can issue a CIT that goes to Segurança Social. Do not assume they can. Expats who pay for international cover, such as Cigna Global, often see private doctors by default, so it is worth confirming the clinic’s process when you book.

The Self-Declaration Route for Short Illnesses

How the Autodeclaração de Doença Works

For a short bout of illness, you may not need a doctor at all. Decreto-Lei 2/2024 created a self-declaration of sickness, often called the “autobaixa.” You declare under oath, through the SNS digital service, that you are sick.

The rules in force as of October 2026 are:

• The self-declaration can cover no more than three consecutive days.
• You can use it up to twice a year.

You submit it through the SNS 24 service, either in the app, on the website, or by phone. A declaration is generated, and you pass it to your employer. For a walkthrough of the app and helpline, see SNS 24 Helpline (808 24 24 24): Triage, Advice, and Sick Notes.

What the Self-Declaration Does and Does Not Do

The self-declaration justifies your absence, so your employer cannot treat those days as unjustified. It does not give you access to Social Security sickness benefit, because no doctor has certified you. Whether you are paid for those days depends on your contract, any collective agreement in your sector, and your company’s policy. Ask HR before you need it.

Remember that you are declaring under oath. This is a convenience for genuine short illnesses such as a stomach bug or a migraine that flattens you for a day. It is not a free holiday. A false declaration has consequences.

A Real-Life Scenario

Tom, a British customer service agent in Lisbon, wakes up with food poisoning on a Monday. He knows it will pass in a day or two. He opens the SNS 24 app, completes the self-declaration for two days, and emails the PDF to his team lead with a short message. He has not used the self-declaration yet this year, so he is well within the limit. On Wednesday he is back at his desk. No waiting room, no doctor, no fuss.

Now picture the same illness dragging into a fourth day. The self-declaration cannot stretch beyond three consecutive days, so Tom needs a doctor to assess him and issue a proper CIT. That leads to the next section.

Getting a Sick Note From a Doctor Step by Step

Through the Public System

If you have a family doctor, this is the most direct path:

1. Call the SNS 24 line or use the app first if you are unsure how serious your symptoms are. The triage nurse may direct you to your health centre, an urgent care service, or home care.
2. Contact your Centro de Saúde and ask for a same-day appointment, known as a consulta aberta or consulta do dia. Say clearly that you need “uma baixa” or “um certificado de incapacidade.”
3. See the doctor, explain your symptoms and your job, and say if you think you will need several days off.
4. The doctor issues the CIT electronically, linked to your utente number and NISS.
5. Check that it appears in your Segurança Social Direta account, the online Social Security portal, after the system updates.
6. Tell your employer immediately and give them the certificate details or a copy if they ask.

No family doctor? You are in good company, as many expats wait a long time for one. You can still be seen at your health centre’s open consultation slots or another public service. What to do if you don’t have a family doctor but need a public consultation explains the options.

Through a Private Doctor or Hospital

Many expats find the private route less stressful, especially in Lisbon, Porto, and the Algarve, where large private hospital groups have English-speaking staff. Hospital da Luz and CUF: Navigating Portugal’s Biggest Private Hospitals covers how those networks work.

The steps look similar:

1. Book an appointment through the hospital’s app, website, or phone line. Mention that you will need a sick note for your employer.
2. Bring your passport or residence card, your utente number, and your NISS.
3. During the consultation, ask the doctor directly whether they will issue a CIT through the electronic system.
4. Get a printed or emailed copy before you leave, along with any prescription.
5. Confirm it has been registered with Segurança Social.

If your private insurance covers the visit, keep every invoice. International plans such as Cigna Global usually ask for itemised receipts when you claim, and you will want the consultation, the certificate, and any medication on record.

Mental Health and Burnout

A sick note is not only for broken bones and flu. Doctors in Portugal issue CITs for anxiety, depression, and burnout too. If you are running on empty, you do not need to be bleeding to deserve rest. See Work burnout in Portugal: Getting a medical leave certificate from SNS 24 for how to raise it with a doctor and what to expect.

Comparing Your Options at a Glance

Route	Who certifies	Maximum length	Sickness benefit eligibility	Best for
Self-declaration via SNS 24	You, under oath	Three consecutive days, up to twice a year	No	Short illnesses like colds or stomach bugs
Family doctor at Centro de Saúde	SNS doctor	Set by the doctor, with extensions if needed	Yes, if you meet Social Security conditions	Anyone registered with a family doctor
Open consultation at a health centre	SNS doctor	Set by the doctor	Yes, if you meet Social Security conditions	Expats without an assigned family doctor
Private clinic or hospital	Private doctor	Set by the doctor	Yes, if you meet Social Security conditions	Expats who want English-speaking care fast
Public hospital emergency department	Hospital doctor	Usually short, followed by a family doctor review	Yes, if you meet Social Security conditions	Genuine emergencies only

A word on that last row: do not go to an emergency room just for paperwork. Emergency departments are for urgent conditions, and you may face a long wait if your case is minor. If you are seen there for something serious, the doctor can issue the certificate as part of your care.

Handling Your Employer and Avoiding Common Problems

Notifying Your Manager the Portuguese Way

Portuguese labour law expects you to tell your employer about an unforeseen absence as soon as you reasonably can. In practice, that means a phone call or message on the first morning, followed by the certificate. A short, polite message works well:

• “Bom dia, estou doente e não vou conseguir trabalhar hoje. Vou enviar a baixa assim que a tiver.”
• In English: “Good morning, I am sick and will not be able to work today. I will send the sick note as soon as I have it.”

Many international companies in Lisbon accept English, but some HR departments run entirely in Portuguese. If the language barrier makes you anxious at the doctor’s office as well, Navigating the public health system if you only speak English (Translation tips) has practical phrases and app suggestions.

Freelancers Play by Different Rules

If you work on recibos verdes as a trabalhador independente, there is no employer to notify. Your eligibility for sickness benefit depends on your own Social Security contribution record, and the process differs in important ways from that of salaried staff. Before you rely on it, read Freelancing in Portugal (Recibos Verdes): Taxes, Social Security, and Setup and check your status in Segurança Social Direta.

Checks, Extensions, and Staying at Home

Once you are on a CIT, a few rules apply:

• Extensions: if you are not better when the certificate ends, go back to a doctor for an extension. Do not just stay home and hope.
• Verification: Segurança Social can ask you to attend a check to confirm your incapacity. Answer the door and your phone, and keep your address up to date.
• Being reachable: a CIT is not permission to fly to Madeira for a beach recovery. Stay reachable at the address on file unless your doctor has authorised otherwise.

While you are stuck at home, set yourself up properly. Pharmacies handle the urgent medication. For longer recoveries, some expats order familiar supplements, electrolyte powders, or herbal teas from iHerb so they are not hunting for brands they recognise while they feel awful. Ask your doctor or pharmacist before combining supplements with prescribed medication.

Your Pre-Illness Checklist

Do this before you get sick:

• Get your Número de Utente and save it on your phone.
• Make sure your NISS is active and linked to your employer.
• Install the SNS 24 app and log in once to confirm it works.
• Create your Segurança Social Direta login.
• Find your health centre’s open consultation hours.
• Save your employer’s absence reporting contact and process.
• If you have private insurance, note which local clinics issue electronic sick notes.

When illness strikes:

1. For a short illness, use the self-declaration if you have used it fewer than two times this year and need no more than three consecutive days off.
2. For anything longer, more serious, or recurring, book a doctor and request a CIT.
3. Notify your employer on day one, then send the document.
4. Confirm the certificate shows in Segurança Social Direta.
5. Return to the doctor for an extension if you are still unwell.

Final Thoughts From Someone Who Has Been There

The Portuguese system can feel opaque at first, especially when you are feverish and reading Portuguese menus on a government app. Once your utente number and NISS are sorted, getting a baixa is far more digital and painless than most newcomers expect. The self-declaration covers the short stuff, doctors in both public and private settings cover the rest, and your main job is to communicate clearly and promptly with your employer.

Set things up while you are healthy. Your future self, curled up under a blanket in a cold Portuguese apartment, will thank you.

Disclaimer

This article is for general informational purposes only and does not constitute professional advice. Laws, prices and regulations vary by location and change over time. Consult a qualified professional for guidance on your specific situation.