Medical Certificate Template - Page 2

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Medical certificate this is to certify that i undersigned dr, physician doctor, certify that mr / mrs. / miss date of birth: consulted me on present no apparent reason for cons indication taking part in running competition. . certificate made at:...

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.theenglishcorner.fr medical certificate first name & surname: address: date of birth: this is to certify does not, at the present time, suffer from any contagious diseases and is in good physical and mental condition. there are no medical...

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Why Do I Need a Medical Certificate Template?

In case of any enduring health problem, there is often the need to be absent from work. Although the rules can be different, every employee has to provide some kind of documentation. Once you decided to take sick leave, you have first of all to inform your employer. The next step is to furnish a medical certificate.

There is a range of other reasons to prepare this template. For example, you apply for a visa or you want to get a medical test. Anyway, there should be legal evidence of your physical state and proof that you have passed a physical examination. Therefore, this sample should be filled by your physician or other health providers. In some cases, you may be required to attach an application for sickness benefits. Note, that it is possible to inform your manager about your illness through a third party.

How to Complete a Medical Certificate Template

A range of fillable templates is available on the website. Choose one that fits your needs the best and fill it out with all the necessary information.

Here is the list of details to include in your medical certificate:

employee's name position and address;

agency name, address, and head or representative;

health condition (hospital care, absence plus treatment, pregnancy, chronic illness requiring treatment, permanent/long-term conditions requiring supervision, multiple treatments (non-chronic illness) or none of the above);

the approximate date the condition commences and it's probable duration;

signature of your physician or examiner;

examiner's name and his or her telephone, license or certificate, issuing state;

whether there are a physician assistant and an advanced practice nurse;

date of signing and expiration date.

E-sign the completed document and send it to your manager. You can print the sample in order to fill it out manually.