This doctor’s note is used to formally excuse an individual from work due to medical reasons. It includes checkboxes for illness, injury, or other conditions, space to mark the duration of leave, and sections for the physician’s name, contact details, and signature.
How to Use This Doctor’s Note
Open the template in Microsoft Word or Google Docs to enter information directly. For handwritten use, print the file or use the fillable PDF version to complete it digitally without editing the layout. Start by entering the date of issuance. Fill in the patient’s name, check the box for “Work” or “Other,” and select the appropriate reason for absence.
Use the provided date fields to define the absence period. At the end of the form, enter the doctor’s name, contact information, and signature. Once signed, this document can be given to the employer or relevant authority as official proof of absence.
This template is designed to document medically necessary absences from work based on a legitimate health evaluation. It should be completed by a licensed medical professional with accurate details, including the reason for absence, relevant dates, and signature. Submitting false or misleading information may lead to workplace consequences and can affect trust between employees and employers. To maintain credibility, this form should be used only when the absence is genuinely required for health-related reasons.
