40 Free Doctor Note Templates (Excuse Slip) for Work, School

A doctor’s note is a slip from a doctor or qualified healthcare provider certifying that an individual is ill and, therefore, unable to fulfill their official responsibilities, such as reporting to work or school. The document contains the doctor’s information, employee name, the reason for the visit, certification of condition, authorization or recommendation, and signature. It authorizes the employer or teacher to excuse the employee or student from all or specific obligations. Other names for such a document include;

  • Sick note
  • Physician’s statement
  • Fit note
  • Work excuse note
  • Medical excuse slip

A doctor’s note template is a predesigned blank document that is filled to create a legitimate sick note. It contains sections or spaces to input all the fundamental details that ought to appear in a professional note from a doctor.

The note is meant to authenticate that you missed or will be missing school or work due to sick leaves or medical reasons. It indicates the type and date of the appointment and the time needed for recovery. The document is typically submitted to fulfill the company’s or school’s medical leave policies. Often, you will not require a medical excuse note for one day’s leaves, but it is mandatory when you have to miss school or work for multiple days. The note may also specify which tasks you are medically able to undertake and which you are prohibited from performing.

Some of the other reasons why you may need to submit a doctor’s note are:

Verify fitness for employment: Some professions, like security guards, military officers, and construction workers, require medically fit employees. Employees in these fields will thus have to submit the doctor’s note to verify they are fit enough to carry out their job specifications.

Verify fitness to play sports: Athletes are expected to pass medical tests before being allowed to participate in sports in school or professionally. A note from the doctor can be used to certify that one is qualified to participate in a certain sport.

Travel authorization: Due to variations in climate, disease prevalence, and other conditions between regions, people traveling to certain destinations are required to prove they are medically fit to travel to their destination. A doctor’s note can be used to this effect. A case in point is the COVID-19 outbreak; most travelers are required to have a note that verifies they are covid free before entering a country.

Verify a physical condition/disability/injury: Doctor’s notes can be used to ascertain that an employee has a medical condition, disability, or injury that prevents him or her from carrying out certain assignments in the workplace or school. The Americans with Disabilities Act (ADA) protects individuals with disabilities from certain exploitations.

The following should, however, be put into consideration:

  • FMLA – The Family and Medical Act protects employees by ensuring they are awarded applicable benefits during their medical leave.
  • HIPAA – The Health Insurance Portability and Accountability Act ensures that the privacy of an individual’s medical information is protected.
  • EEOC – The Equal Employment Opportunity Commission allows employers to request their employee’s medical information provided the information is job-related and impacts the employer’s requirements.

Doctor’s Note Templates

A ‘doctor’s note template’ is a blank form that individuals can use to justify their absence from work or school due to medical reasons or to apply for additional sick leaves. The template outlines all the necessary sections that must appear on the absence authorization, and the user can then fill in the blanks accordingly. The doctor’s note template can also be used to write an absence excuse slip or email it to the manager or supervisor.

Free Doctor Note Template - Printable Sample

Doctor Note Template - Word Document Example

Download Free Doctor Note Template - Editable Version

Doctor Note Template - Free Sample

Doctor Note Template - Printable Format Example

Doctor Note Template - Printable Format Example

Doctor Note Template - Editable Example

Download Free Doctor Note Template - Printable Version

Doctor Note Template - Example Format

Free Doctor Note Template - Word Document Format

Doctor Note Template - Printable Sample

Doctor Note Template - Editable Word Document Example

Free Doctor Note Template - Downloadable Sample

Doctor Note Template - Printable Format for Free

Doctor Note Template - Word Document Sample

Free Doctor Note Template - Editable Format

Doctor Note Template - Printable Example

Download Free Doctor Note Template - Sample Format

Doctor Note Template - Editable Word Format

Free Doctor Note Template - Printable Format

    When Do You Need a Doctor’s Note Template

    A template offers a quick method of creating a professional and presentable doctor’s note. It is designed to be easily customized to suit different work or school needs and requirements. Companies can create their own templates that document the dates employees will be absent from work, contact information, and doctor recommendations. Also, such templates can be edited to reflect new policies and company brands.

    Suppose it is being used for an insurance claim. In that case, insurers can add extra fields to record additional information such as ICD (International Classification of Diseases) codes, CPT (Current Procedural Terminology) codes, prior referrals or authorization for the treatment, physician’s details, and billing information. Hospitals, doctor’s offices, and clinics can also create templates that include their business logo and letterhead to distinguish their internal documents from external notes. Lastly, if you want to create a fake doctor’s note, it is advisable to use a template as they are designed to add a professional and authentic look to your note.

    Types of Doctor’s Note Template

    There are multiple types of free note templates for doctors to craft an excuse slip for their patients. The templates have varying formats that suit different circumstances. Below are several types of doctor’s notes and the differences in formats.

    Excuse Note for Work Template

    Free Excuse Note for Work Template

      This generic template highlights the information needed to seek a formal excuse from work due to medical reasons. It starts with the date and time of the visit, the patient’s details such as age, gender, and address, then the doctor’s information such as their name and medical facility. It then indicates the doctor’s diagnosis, recovery time, and other recommendations needed for recuperation. It must also be signed.

      Urgent Care Doctors Note Template

      Printable Urgent Care Doctors Note Sample

        Such a template can be used to write an excuse note when a patient has an emergency medical concern that may force them to miss work or school. This template starts with the doctor’s information, such as name, designation, specialty, degree, and the facility’s name, address, location, and phone number. Other details, such as the patient’s name, date of visit, diagnosis, recovery time, and treatment, can be added in the body section of the note.

        Doctors Note for School

        Editable Doctors Note for School Sample

          This template is specifically meant for crafting excuse notes for students. It is used to record when the student visited the doctor, the certification of the condition, and what the doctor authorizes in terms of recovery time and treatment.

          Doctors Sick Note Template

            This simple template records basic information when justifying absence from work or school. The first section captures the medical facility’s name, address, phone number, email, and website. This is followed by the patient’s details, prescription, recommendation, and signatures. It also has to be dated.

            Return to Work Doctors Note

            Free sample Return to Work Doctors Note

              A doctor’s note can guide how a patient will transition back to school or work. It is sent when a patient is treated and ready to resume school or work. This template identifies the doctor, the patient, the diagnosis, and the authorization of full-duty or light-duty resumption. It can also recommend not to resume work/school until a specified date. The template enlists the associated restrictions, such as no climbing, lifting, or bending, and the limitations, such as the number of hours per day, breaks between work, or use of protective gear.

              Elements of a Doctor’s Note Template

              There are different types of templates for writing medical excuse notes that vary in format. However, there are specific elements that are common in all doctor’s notes. Since medical information is sensitive, medical providers will want to be compliant with HIPAA (Health Information Portability and Accountability Act). HIPPA prevents health professionals from sharing sensitive patient information with third parties. Below is a comprehensive list of information that should be included in a doctor’s note template.

              Patient Information Section: This part of the template should have blank spaces for the doctor to fill in the patient’s full name, date of birth, address, age, and any other necessary information.

              For example:

              Patient: Jane Doe
              Age: 21

              Date Section: The template must include a space for the doctor to enter the date the note was issued, ideally, the date of the appointment. The date is essential for verifying the accuracy of events and their timeline.

              For example:

              Date: 8th August 20xx                                     Time: 11:00

              Doctor Details Section: The template should have designated areas for the doctor’s name, address, and phone number, as well as details about the medical facility. Providing such information enhances the credibility of the note.

              For example:

              Physician: Dr. John Doe
              Title: Chief surgeon
              Medical facility: Happiness Memorial Hospital
              Address: 533 Marble Street, Charlton, MA 4309

              Reason for Appointment Section: The template should include a space for the doctor to specify the reason for the patient’s visit. Reasons can range from injuries and illnesses to specific medical conditions, such as the flu or a cold.

              For example:

              Kindly excuse the named person from Work                      due to:

              Illness
              Injury
              Other

              Diagnosis Section: This part of the template should provide space for the doctor to note their findings regarding the nature and cause of the medical issue. The information in this section must comply with HIPAA guidelines to ensure the patient’s privacy is protected.

              For example:

              After a thorough examination, I, Dr. John Doe, certify that the named patient has the medical concerns mentioned in this document.

              Treatment Section: The template should include a designated area for the doctor to outline the medication and directives prescribed. The prescription can be presented in a list format.

              Recovery Time Section: If the patient requires a significant recovery period, the template should have a space for the doctor to record the duration in terms of days. This information allows employers to plan for the employee’s absence accordingly.

              For example:

              The leave shall be applicable from 8th August 20xx To 20th August 20xx.

              Restrictions Section: The template should have a section for the doctor to specify any authorized activities or tasks the patient can perform and the type of work they should avoid. For students, the note should outline permitted and restricted play activities. This information helps the employer or school support the patient’s recovery process.

              For example:

              The patient is advised to abstain from:

              Manual heavy workload such as lifting heavy bags or using heavy equipment
              Walking long distances
              Working for more than 6 hours in a day without rest

              Signature Section: The template must include a space for the doctor’s signature and license number to attest to the authenticity of the note. The doctor’s signature and license number provide further validation for the document.

              Follow-up Appointment Section: This part of the template should include a space for the doctor to indicate if a follow-up appointment is necessary and when it should take place. This information is essential for both the patient and the employer or school to ensure proper medical care and monitoring.

              Doctors Note Template Explained
              This infographic explains the contents and format of a doctor’s note.

              Note: The medical excuse slip or a doctor’s note is an official document that should be specific, concise, and accurate. The requestor should be able to comprehend the medical issue, and the document should be concise and convey only the relevant information. The information provided should be accurate as the note is a legal document and may be subject to consequences as per the applicable policy or jurisdiction.

              The Legitimacy of a Doctor’s Note 

              A legitimate sick note prevents disputes with management or school authorities as it is considered to be more credible. Several elements contribute to the legitimacy of a doctor’s note. Examples of such properties include;

              The authenticity of its information: Authentic details that can be used to verify the credibility of the note should be provided. These include the doctor’s name, mailing address, phone number, and email address. Employers or administrators use this information to contact the doctor to verify the credibility of the note.

              Professional letterhead: Letterheads are added to an entity’s formal documents. So, the presence of the facility’s letterhead in a note is an indicator of its legitimacy. A prescription pad can also be used to serve the same purpose.

              Doctor’s signature: Signatures are indicators of formal attestation by the doctor that the provided information is true and reliable. Signed sick notes are thus deemed more credible than unsigned ones.  

              Licensing and qualification of the physician: Only qualified or licensed doctors can write a note of absence from work or school due to medical reasons. Doctors can add their license number for this purpose. 

              Consequences of Using a Fake or Forged Doctor’s Note

              While fake sick notes can be used, especially when urgent care is needed or suffering from a condition that can be treated using over-the-counter medications and does not want to visit a doctor. It is immensely important to use legitimate medical excuse notes. This is because should the employer or school decide to verify its legitimacy, you are protected from the consequences of using fake notes to excuse yourself from work or school. There are potential consequences of forging an excuse note in order to miss work or school. However, these consequences will vary from case to case. So, it is important to understand what you may be liable for if you use a fake note in the situation at hand. 

              The potential for negative effects on personal and professional reputation

              The more general consequence is that it can destroy your professional reputation at work or school. Your employer or teachers will have a negative impression of you when they discover you forged the note to evade your obligations. A fake doctor’s note can result in job suspension or termination in the workplace, depending on company policy.

              The legal implications of using a fake doctor’s note 

              Other than ruining your reputation, a fake note may hold you liable for forgery, identity theft, or fraud from impersonating a professional healthcare provider. Since a fake excuse slip is falsifying information, an offense that is prosecutable under most jurisdictions. Forging the note is a fraud, especially when an employee is paid for the days they were absent from work or files for insurance claims with the note as evidence of a medical condition. This may also lead to permanent dismissal from work or school.

              Free Templates

              Making a doctor’s note template is easy. A person will download the template and fill in the information for their local doctor’s office or health care clinic. They will type on the date that they missed work. They will fill in their name and related information. A person will then type in the dates in which they play to miss work and the date on which they are able to return to work. Once this information is customized, it can be printed off and sent to the employer. The note will have all the information from a real doctor’s note, including a signature.

              Following are some free downloadable doctors note templates for you:

              Doctor Note Template - Editable Format Example

              Doctor Note Template - Free Printable Example

              Download Free Doctor Note Template - Word Document Format

              Doctor Note Template - Sample Format Example

              Free Doctor Note Template - Printable Version

              Doctor Note Template - Editable Word Document Sample

                How to Obtain a Doctor’s Note 

                The process of obtaining a valid note from a doctor is relatively straightforward. This process can work for any party requiring official authorization to miss official duties, whether at work or school. Here are several steps to follow for this process.

                Step 1: Review the policy

                Start by reviewing the applicable policy in your organization. Some companies and schools allow several unexcused absences before requiring a note from a qualified doctor. The policy also directs what information should be included in the note. This step ensures you remain compliant and recover without confrontations with your supervisors.

                Step 2: Visiting a doctor or urgent care facility

                Once you know what your employer or school requires to validate that you were away due to medical reasons, schedule an appointment with the doctor. You can opt for a primary care doctor, urgent care medical provider, or specialist. On the scheduled appointment day, visit the doctor and be sure to be on time for the scheduled appointment.

                Step 3: Explain Your Situation

                Explain your concerns at the doctor’s office in a simple but specific manner. The doctor will examine you and perform tests to determine your medical condition. They will then diagnose your condition and prescribe the right treatment, recovery time, and restrictions needed to ensure you recuperate fully.

                Step 4: Take your Own Doctor’s Note Template

                To ensure the note contains all the information your employer or school needs, take your customized template to the doctor’s office. You can download free templates from here and personalize them to suit your needs. Most can be edited via MS Word or popular word processing tools. Templates simplify the process and produce a note that complies with company or school policies.

                Step 5: Obtain the Note

                The doctor then completes the template accordingly with the required information. Also, make sure they have signed and dated the note to authenticate it. They can also indicate their license number for additional credibility.

                Step 6: Submit the Note

                Lastly, submit the note to the relevant authority at work or school. At work, this can be your direct supervisor or HR. You can submit it to the department head, class teacher, or student affairs office in school.

                Some Best Practices for Using a Doctor’s Note Template

                There are practices you can adopt to make the templates you use more effective for crafting professional medical excuse slips. These practices range from formatting guidelines to how you handle the process of excusing yourself from work for medical reasons. Some of these practices are as follows;

                • Use a Legitimate Template – Always use a professionally designed template that contains all the relevant information. Remember that a sick note is an official document and, therefore, should be prepared with formality.
                • Customize the Template – After downloading a free template, do not use it “As-Is”; rather, customize it to include all necessary information, such as your personal information, the reason for the visit, and expected recovery time. You can use MS Word to undertake this exercise.
                • Use a Clear and Concise Format – When selecting templates, go through several and review their formats. Choose one with a clear and concise format that is presentable and outlines all the sections in the correct positions.
                • Obtain a Signature – A signed note from a doctor is more credible than one that is not signed. So, always ensure that a signature from a licensed medical professional is provided to authenticate the note. The signature should be at the bottom of the note.
                • Follow Policies – The template you present to your doctor to complete should follow the policies and procedures of your employer, school, or the respective organization. This guarantees that the information provided is exactly what the authorizing party in your organization needs.
                • Keep the Template Confidential – Once customized to include your details and those of your employer or school, keep the template confidential and only share it with the necessary parties. Also, do so once the doctor completes it. Personal identification details and medical information is sensitive and should thus be protected.
                • Use it appropriately – Use the doctor’s note template only when necessary and avoid abusing its use. You can use it when you have a sudden short illness and to verify fitness for employment, travel, or sports at school or work after a medical issue.

                Frequently Asked Questions

                Are fake doctor’s note templates legal?

                No. It is considered forgery under the law even though people still use them when they want time off from work or school. So, you must understand the probable consequences and use one at your own discretion. Employers and schools are allowed to call the named doctor to verify the legitimacy of the note.

                How can I ensure the legitimacy of a doctor’s note template?

                First, ensure that your doctor is qualified. Then, ask them to add the following information: a signature, date, and license number. The health facility logo and business identification details can further increase the legitimacy of your sick note. 

                Are all doctor’s note templates the same?

                Even though medical excuse slips serve the same purpose, they are different. Different types of such notes vary based on the circumstances and format. For example, a note for missing school will be less detailed than one for filing an insurance claim.

                Can I customize a doctor’s note template?

                Yes. It is advisable to personalize a template before it is presented to the doctor to complete. Make sure it abides by the company’s or school’s policies. You can add or remove sections your employer or school does not need.

                Can a doctor’s note template be used for any medical condition?

                The note can be used for any medical condition that causes an individual to miss school or work. It can be used when a person is to miss work/school entirely or is restricted from undertaking certain activities due to a medical condition.

                Can employers or schools request additional information beyond what is included in a doctor’s note template?

                Requestors can ask for additional information regarding an employee’s medical condition if the request relates to their ability to perform their duties and is consistent with business necessity. However, the request must also comply with HIPAA and EEOC (Equal Employment Opportunity Commission) guidelines. Upon receiving the information, employers and schools must follow the applicable confidentiality regulations.

                About This Article

                Susan Cain
                Authored by:
                Writing Authority | Research Specialist | Public Relations Graduate
                Boasting a decade-long career in the content creation arena, Susan Cain has carved a niche for herself as a leading expert in the field. A graduate in public relations, her writing acumen is complemented by her rigorous research skills, making her a dual asset in both content generation and data-backed storytelling. With a keen eye for detail and an academic background in public relations, Susan seamlessly blends persuasive narrative with factual depth, providing content that is both engaging and enlightening. Her multifaceted expertise not only establishes her as a prominent content writer but also as a thought leader in leveraging the symbiotic relationship between effective communication and substantive research.

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