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Medical Clearance Letter
You must have a Medical Clearance Form on file with the company if you are going to participate in the company marathon relay race in the fall. Please have your Doctor complete the form as soon as possible and bring the completed form down to the HR office to begin the training program.

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


Medical Clearance Letter TemplateForm 1534
Format: Word PDF
Category: Medical, Hospital
Type: Letter

Medical Clearance Letter

[Your Name]

[Address]

[City, State, Zip]

[Date of letter]

[Recipientís Name]

[Title]

[Company Name]

[Address]

[City, State, Zip]

Re:

Patientís Name: _______________________

DOB: ___/___/_____

SS#:___-__-____

Dear [Recipientís name],

The above mentioned patient was seen in our clinic today for the following reasons:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Due to the above listed medical condition, the above named patient is medically cleared for the following:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Best regards,

[Your Signature]