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Revised: 08/06/2024DONNA INDEPENDENT SCHOOL DISTRICT Request for Extended Leave Professional EmployeeMedical certification of illness or injury MUST be attached to this request. Name (Official Name): ___Employee ID:___Campus/Department: ___ Position: ___ Donna ISD Board Policy DEC (Local) After all available paid leave days and any applicable compensatory time have been exhausted, a professional employee shall be granted in a school year a maximum of 20 leave days of extended sick leave to
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How to fill out medical certification of illness
How to fill out medical certification of illness
01
Obtain the medical certification form from the relevant authorities or employer.
02
Fill in the patient's personal information, including their name, date of birth, and address.
03
Provide details of the medical condition, including diagnosis and symptoms as noted by the physician.
04
Indicate the date of the medical examination and any relevant medical history.
05
Specify the duration for which the patient is advised to take sick leave.
06
Include the physician’s information, such as name, medical license number, and contact details.
07
Sign and date the certification to validate the information provided.
Who needs medical certification of illness?
01
Employees taking time off work due to illness.
02
Students requiring an excuse for absences from school.
03
Individuals applying for disability benefits or insurance claims.
04
Athletes needing to certify an injury for participation in sports.
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What is medical certification of illness?
Medical certification of illness is a document provided by a healthcare professional that verifies a patient's medical condition and the necessity for absence from work or school due to illness.
Who is required to file medical certification of illness?
Generally, employees who are absent from work due to a medical condition may be required to submit medical certification of illness to their employer, especially if their absence exceeds a certain duration or is related to specific policies.
How to fill out medical certification of illness?
To fill out a medical certification of illness, a healthcare provider typically completes sections that include the patient's name, date of examination, diagnosis, duration of illness, and any recommended restrictions or accommodations.
What is the purpose of medical certification of illness?
The purpose of medical certification of illness is to provide an official record of a person's health condition, justify absence from work or school, and ensure that appropriate measures are taken regarding the individual's health and employment responsibilities.
What information must be reported on medical certification of illness?
The information that must be reported on a medical certification of illness typically includes the patient's name, diagnosis, date of assessment, expected duration of illness, and any limitations or special accommodations needed.
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