← Incapacidad temporal (IT)

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First and last names Required DNI or NIE Required 🔒 Stored encrypted; only used to generate your draft. Date of birth Required 📅 Format: DD/MM/YYYY 🔒 Stored encrypted; only used to generate your draft. Address Required Type of contingency Required — Comun Profesional Sick-leave start date Required 📅 Format: DD/MM/YYYY 🔒 Stored encrypted; only used to generate your draft. Doctor who issued the baja Required 🔒 Stored encrypted; only used to generate your draft. Health centre (centro de salud) Required Base reguladora for previous month (€) Required 🔒 Stored encrypted; only used to generate your draft. Contribution regime Required — Regimen general Autonomos Agrario Hogar Mar Otros Does your employer top up via collective agreement? Required — Yes No

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