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Doctor's Note For Work
Many companies require a legitimate Doctors Note before you are permitted to return to work. The following document is an excuse template that you can have a doctor fill out, or as a doctor you can efficiently use as a printable form for your patients when requested.

Free Sample Template
Format: Word PDF
# of Pages: 1
Printable: Yes


Doctor's Note For Work TemplateForm 4108
Format: Word PDF
Category: Medical, Doctor Office
Type: Note

Doctor’s Note for Work

[DOCTOR’S NAME]

[ADDRESS]

[CITY, STATE ZIP CODE]

DATE: ___/___/_____

PLEASE EXCUSE: _____________________________________________

FROM:

___ Work

___ OTHER: _______________________________________________

DUE TO:

___ INJURY

___ ILLNESS

___ OTHER: _______________________________________________

FOR THE FOLLOWING DATES:

___/___/_____ TO ___/___/_____

Thank you,

_________________________________________________________