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Fillable Form Medical Excuse Note

A Document from a Doctor which attests to the result of a medical examination of a patient. It serves as a documentation that an employee is unfit for work or as an evidence of a health condition.

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What is a Medical Excuse Note?

Medical Excuse Note: Doctor's letter for work absence

A Medical Excuse Note, also known as a Work Excuse Note or a Doctor's Note, is a brief letter explaining an individual's absence from work or the need for future time off. Typically, these notes are accompanied by medical certification or other documents to authenticate the reason for absence.

Employers often require excuse notes to ensure the legitimacy of an employee's absence. Failure to provide an acceptable explanation may lead to consequences based on workplace policies, potentially disrupting operations or violating agreements between the employee and employer.

Various reasons, such as injury, illness, or personal emergencies, can necessitate time off work. The purpose of a Medical Excuse Note is to inform employers of a medical reason for absence. However, it's important to note that these notes usually aren't legally binding, so understanding workplace policies is essential to anticipate any repercussions or responsibilities associated with absence.

How do I fill out a Medical Excuse Note?

Get a copy of Medical Excuse Note template in PDF format.

Medical Excuse Note/A doctor fills out a Medical Excuse Note for a patient's work absence

Fillable and free doctor note templates can be found here. Make sure that all information that is entered in the note is accurate and correct, preferably with documentation to verify it as well.

Doctor’s Name

Enter the name of the doctor that performed the examination and is certifying this excuse note.


Enter the address from which the doctor works.


Enter the date that this excuse note was created.

Name of Excused Person

Enter the full legal name of the person that was examined and will be excused.


Check the box that applies to what the above named person is being excused from. You may choose one from the following:

  • Work
  • School
  • Other (Specify in the space provided)

Due To

Check the box that applies to the reason why the above named person should be excused. You may choose any of the following:

  • Injury
  • Illness
  • Other (Specify in the space provided)

Make sure to attach the necessary documents in order to prove that these reasons are true.

For the Following Dates

Enter the date from which the person is requesting to be excused, and until what date the person will be excused.

Doctor’s Comment

If the doctor has any other comments or notes, have them enter those comments or notes in the space provided.

Doctor’s Signature

Have the doctor sign the form in the space provided.

Doctor’s Name

Enter the doctor’s name.

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Frequently Asked Questions (FAQs)

Do you have to provide a medical note for all medical conditions?

A medical note is usually required for specific situations like missing work or school due to illness or injury. However, its necessity depends on the policies of your employer or school and the circumstances, as well as the diagnoses reached by the doctor after your medical appointments and checkups.

What are the consequences of forging a medical note?

Creating fake doctor's notes is a serious offense with potentially severe legal repercussions, including criminal charges. It's crucial to be truthful and follow proper procedures to avoid legal trouble. Using a doctor's note template or obtaining an official doctor's note online is fine, as long as a medical professional certifies the information within the doctor excuse note as valid. Fake doctor's note documents will generally have forged or incorrect information on them - in some cases, fraudsters will pose as medical professionals and forge doctor's excuse notes to trick people into paying them. Make sure that you are obtaining your medical note(s) or are having your medical note(s) verified by actual, licensed medical professionals.

Are there instances where a medical note might be rejected?

Medical notes might be turned down if they lack essential details or are suspected of being fake. They could also face scrutiny if they don't meet the employer's or school's requirements or if they're from unlicensed professionals, or if the doctor's note templates used are not recognized as valid. If such situations occur, make sure to consult with your Human Resources department and your doctor to see if another real doctor's note is needed or if more doctor appointments are necessary in order to verify the condition you are reporting.

Can you get a medical note for a dental procedure?

Yes, a dental procedure can warrant a medical note to explain the need for time off due to associated pain, discomfort, or recovery, especially if more than one appointment is needed over an extended period of time.

Is a medical note necessary for prescription medication use?

Typically, a medical note isn't required for prescription medication use unless the medication's side effects impact your ability to work or attend school. In such cases, you might need a note to explain specific limitations as discussed during your doctor's appointment.

How can you ensure a medical note's authenticity?

To verify a medical note, attach copies of the diagnosis and prescriptions, all signed by the diagnosing doctor.

Can a medical note cover chronic health conditions?

Yes, medical notes can justify time off for chronic health issues and may be issued by specialists or primary care physicians.

Do schools or employers have the right to contact the issuing medical professional?

Yes, they can verify the note's authenticity or address medical concerns, but only with the patient's consent and within the bounds of patient confidentiality laws.

Can you get a medical note for a family member?

Typically, medical notes are for the patient, but if you're caring for a family member and need time off, you can discuss accommodations with your employer or school.

What if your medical note is lost or damaged?

Contact your healthcare provider for a replacement copy or confirmation of your medical condition.

Can you get a medical note for elective procedures?

Yes, providers performing elective procedures can issue medical notes detailing necessary time off or restrictions during recovery.

Is a medical note needed for a single-day absence?

It depends on your employer's or school's policies; some may not require it for very short absences, but it's essential to check their rules.

Can you get a medical note for an untreated condition?

Yes, if necessary to explain the need for time off, you can obtain a medical note for an untreated condition, though this will naturally require evidence of the condition and details about the treatment.

Are medical notes applicable to military service-related absences?

Military service-related absences are usually documented through military orders rather than medical notes.

What if your healthcare provider won't issue a medical note?

Consider seeking a second opinion or discussing alternatives with your employer or school.

What is the Medical Leave Act?

The Medical Leave Act, often referred to as the Family and Medical Leave Act (FMLA) in the United States, is a law that entitles eligible employees to take unpaid, job-protected leave for specified family and medical reasons.

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Keywords: medical excuse note doctor note doctors note fake doctor note note from a doctor

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