Job Leave Medical Form

Medical Leave and Authorized Forms

Every employer sets aside a certain number of days which can be availed by employees for medical leave. The number of days varies in different organizations. However, this leave can be availed at any time of the year by filling out a job leave medical form. This form provides comprehensive medical information to an employer about an employee in order to approve the leave request.

A medical leave form consists of the applicant’s particulars such as name, national identity number, sex and age. In addition, it is also very important for the name and signature of the physician to be on the form in order to verify the patient’s physical condition. The physician provides a brief diagnosis of the applicant’s illness and recommends the number of days he/she should take off for rest at home. The format of the job leave medical form may vary slightly according to different organizations which require certain information to be presented as mandatory for the leave request.

By signing the medical leave form, a physician takes responsibility for the validity of the provided information. In this way, it is ensured that employees do not misuse this form by presenting misinformation for the approval of leave without any justified reasons.


This medical form can be requested by an employee in order to seek leave from office. Alternatively, doctors may also prescribe rest from work to their patients through this form. Therefore, it is a very important piece of paper in the working world.

job leave medical form template

Medical Leave Form Template
Microsoft Word document file | File size 71 KB | Download

Simi Karton

Simi Karton is a regular contributor to National Science Quarterly and an enthusiastic Lakers fan. She recently collaborated on a manuscript with friends and colleagues. Dr. Simi Karton, entitled Parkinsons and the Genetic Response to Eastern Medicine, in which she and Dr. Inshal presented research compiled during a summer spent in United States. She currently resides in Los Angeles with her husband. This website is a voluntary work of Dr. Karton to provide people with useful health related information stuff at an easy approach. The information has been collected from different sources at one place.

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