Fill in the Blanks Doctor Notes

A doctor’s note also referred to as a sick note, is a medical or doctor’s certificate to attest medical examination of a person. This is a written document by a doctor or health care professional in which s/he states the condition of the patient examined by him/her. This serves as an evidence of the health condition of an individual. In the case of an employee, it may serve as a sick note to be provided to the employer stating that the employee is not fit to work.

Due to the credibility of doctors, this note is given significant importance. There are many templates available for doctor notes and sometimes the doctors design their own templates which can be customized for different patients. The doctor’s note may contain information such as:

  • Date
  • Details of the patient
  • Details of the doctor/physician
  • Details of the examination and health condition of the patient
  • Confidential content (only if allowed by the patient)

Usually, fillable doctor notes are used by doctors. These are pre-designed notes with the general information and the blanks that need to be filled with the patient information. It has the following benefits:

  • It is easy and quick to use and fill.
  • The hand-filled note is considered more credible as it confirms personalized attendance.
  • Fewer chances of forging are there and hence increases accountability and responsibility of doctors.

There are many types of doctor notes that are used for different purposes and different scenarios. Some of those are:

  • Doctor appointment note for work – this states that the patient has an appointment with a certain doctor.
  • Doctor note for return to work – the employer may demand a sick note when the employee returns back to work after a sickness.
  • Doctor note for missing work – when the employee misses work due to health conditions, he may need to get a doctor’s note from his doctor.

Therefore, a doctor’s note is an important document that may be kept in the employee record as well as in the doctor’s records.

A Sample Fill-in-the-Blank Doctor Note

Name, Address, and number of the hospital/ health center

Doctor Excuse Slip

Date __________________

This is to assert that Mr./ Ms./ Miss [NAME HERE] had an appointment at [TIME] o’clock.

[TEXT] Please excuse this absence.

[NAME HERE] may return to work on [DATE].

[NAME HERE] would return to work without any further limitations.


                                                                                                                         Physician’s Signature


Fill in the blanks Doctors Notes

MS Word [.docx]

You may also like...