Medical Certificate Template

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.

Video Tutorial How to Fill Out Medical Certificate Template

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It's useful, but the printing function always not smooth (need retry and print i...
It's useful, but the printing function always not smooth (need retry and print it out, with PDFfiller marks sometimes)
Kong S.
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I love the ease of completing the forms.
I love the ease of completing the forms. I have completed over 30 documents and each one was easy to find in the library once I put the document number in. I love the fact that you can choose which pages you would like to print. Another great feature is it saves each document automatically and you can save the completed document to another device.
Dana
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I love the ease of completing the forms.
I love the ease of completing the forms. I have completed over 30 documents and each one was easy to find in the library once I put the document number in. I love the fact that you can choose which pages you would like to print. Another great feature is it saves each document automatically and you can save the completed document to another device.
Dana O.