Table of Contents
A doctor's excuse note is a formal document from a healthcare provider that verifies a patient's medical appointment and justifies their absence from work or school. Whether you're a physician writing these notes daily or an employee wondering what your rights are, understanding the proper format, legal requirements, and privacy protections is essential in 2026.
1. What to Include in a Doctor's Excuse
A legitimate doctor's excuse note must contain specific elements to be considered valid by employers and schools. Here's what every medical excuse should include:
Required Elements
Official Practice Letterhead
Includes practice name, address, phone number, fax, and email. This is the first indicator of legitimacy.
Patient Information
Full legal name and date of birth to identify the patient (NOT Social Security number).
Date of Examination
The specific date the patient was seen by the healthcare provider.
Dates of Excused Absence
Clear start and end dates for when the patient should be excused from work or school.
Return-to-Work Date
When the patient is cleared to return, or a follow-up appointment date if ongoing evaluation is needed.
Work Restrictions (if applicable)
Any limitations such as “no heavy lifting,” “light duty only,” or “work from home recommended.”
Physician Signature & Credentials
Handwritten or electronic signature with MD/DO/NP/PA credentials and medical license number.
What NOT to Include (Privacy Protection)
- ✗Specific diagnosis – Employers cannot legally require this for standard sick leave
- ✗Detailed medical history – Violates HIPAA and patient confidentiality
- ✗Test results or lab values – Not necessary for excuse verification
- ✗Treatment details or medications – Protected health information
- ✗Social Security number – Creates identity theft risk
Sample Medical Excuse Language
[Practice Letterhead]
Date: [Current Date]
To Whom It May Concern:
This letter confirms that [Patient Name], DOB [Date of Birth], was seen in our office on [Date of Visit] for evaluation of a medical condition.
The patient is excused from work/school from [Start Date] through [End Date] and may return to full/modified duty on [Return Date].
[If applicable: Work restrictions: _____________]
Please contact our office at [Phone Number] if you have questions regarding this documentation.
[Physician Signature]
[Printed Name], [Credentials]
License #: [Number]
2. Types of Medical Excuse Templates
Different situations require different types of medical excuse documentation. Here are the most common types:
🤒 Standard Sick Leave Note
For short-term illnesses like flu, cold, or stomach bug requiring 1-3 days off.
- • Simple confirmation of visit
- • Dates excused and return date
- • Usually no diagnosis required
- • Most common type requested
🏥 Extended Medical Leave (FMLA)
For serious health conditions requiring extended time off under FMLA.
- • Uses DOL Form WH-380-E/F
- • Confirms “serious health condition”
- • Estimated duration required
- • May need periodic recertification
⚠️ Work Restrictions/Light Duty
For conditions requiring modified duties rather than complete absence.
- • Specific restrictions listed
- • Duration of restrictions
- • Examples: no lifting >10 lbs, seated work only
- • Common for injuries and pregnancy
📚 School Absence Note
For students (K-12 or college) missing class due to illness or appointments.
- • Confirms medical appointment
- • Specific dates/times missed
- • May need to be addressed to school
- • Often has shorter deadlines
⚖️ Jury Duty Medical Excuse
Medical documentation to request exemption from jury service.
- • Explains medical condition prevents service
- • Addressed to court/commissioner
- • May require more detail than work notes
- • Temporary or permanent exemption
✅ Return-to-Work Clearance
Confirms patient is medically cleared to resume work duties.
- • States “cleared for full duty”
- • Or specifies remaining restrictions
- • Often required after extended leave
- • May be required by employer policy
3. Legal Requirements (FMLA, ADA, HIPAA)
Understanding the legal framework around medical excuse notes protects both patients and providers. Here's what you need to know about federal protections in 2026:
Family and Medical Leave Act (FMLA)
Eligibility Requirements
- • Worked for employer at least 12 months
- • Worked at least 1,250 hours in past year
- • Employer has 50+ employees within 75 miles
- • Provides up to 12 weeks unpaid, job-protected leave
Documentation Rules
- • Employer may request certification within 15 days
- • Must confirm “serious health condition”
- • Employer CANNOT require specific diagnosis
- • Cannot require note for each intermittent absence
Americans with Disabilities Act (ADA)
Applies When
- • Employers with 15+ workers
- • Employee requests reasonable accommodation
- • FMLA leave is exhausted but more is needed
- • Employee has qualifying disability
Documentation Limits
- • Only when disability/need not obvious
- • Cannot request complete medical records
- • Must relate to specific accommodation request
- • Additional leave may be required beyond FMLA
HIPAA Privacy Protections
What Providers CAN Share
- • Confirm note was issued by their office
- • Verify dates on the note
- • Confirm the note is authentic
- • General confirmation patient was seen
What Providers CANNOT Share
- • Specific diagnosis without consent
- • Treatment details or medications
- • Test results or lab values
- • Any medical information beyond the note
Key Point: Medical information must be kept confidential and stored separately from other employment records. Employers cannot share medical details with other employees or managers who don't have a legitimate need to know.
4. How Employers Verify Medical Notes
Employers have legitimate reasons to verify medical documentation, but the process is regulated to protect patient privacy. Here's what employers can and cannot do:
Legitimate Verification Methods
Call the Medical Office
Employers can call the phone number on the letterhead to confirm the note was issued by that practice. The office can verify authenticity without disclosing medical details.
Check Medical License Databases
Verify the physician's license number against state medical board databases to confirm the provider is licensed and in good standing.
Review Document Authenticity
Check for official letterhead, proper formatting, verifiable contact information, and authentic signatures. Digital verification services can help analyze documents.
Red Flags That May Indicate a Fake Note
- ⚠️Generic or poor-quality paper without letterhead
- ⚠️Contact information that can't be verified
- ⚠️Missing or suspicious signature
- ⚠️License number that doesn't check out
- ⚠️Dates that don't align with reported absences
- ⚠️Inconsistent formatting or typos
- ⚠️Overly detailed medical information (unusual)
- ⚠️Practice name doesn't appear in online searches
Consequences of Using a Fake Doctor's Note
Using a fraudulent medical excuse is illegal and carries serious consequences:
- • Immediate termination from employment
- • Criminal fraud charges in some jurisdictions
- • Permanent damage to professional reputation
- • Difficulty finding future employment with this on record
- • Potential civil liability for any harm caused
5. Free Downloadable Templates
Below are template formats for different medical excuse scenarios. Healthcare providers can customize these for their practice:
📋 Standard Work Excuse
Basic template for short-term illness requiring 1-5 days off work.
Best for: Flu, cold, minor illness, routine appointments
⚠️ Modified Duty/Restrictions
Template specifying work limitations rather than complete absence.
Best for: Injuries, pregnancy, post-surgical recovery
📚 School Absence Note
Template for K-12 or college student medical absences.
Best for: Student illness, medical appointments during school
✅ Return-to-Work Clearance
Template confirming patient is cleared to resume work duties.
Best for: After extended leave, post-injury, employer requirement
6. Best Practices for Healthcare Providers
Healthcare providers write dozens of medical excuse notes monthly. Following these best practices ensures compliant, efficient documentation:
1Use Standardized Templates
Create pre-formatted templates in your EHR system with required fields. This ensures consistency, reduces errors, and speeds up documentation. Include all necessary elements while omitting unnecessary medical details.
2Protect Patient Privacy
Never include diagnoses unless specifically required by law (e.g., certain FMLA certifications). Generic language like “medical condition” is sufficient for most purposes. Train staff on what they can and cannot disclose when employers call to verify.
3Be Specific About Dates and Restrictions
Vague notes create problems. Clearly state the exact dates of excused absence and any work restrictions. If restrictions are indefinite, specify a follow-up date for re-evaluation.
4Document in the Medical Record
Keep a copy of all excuse notes in the patient's chart. Note when and why the excuse was issued. This protects against disputes and helps with future requests.
5Know When to Refer to FMLA Forms
For extended leave or serious health conditions, employers may require official DOL forms (WH-380-E for employee, WH-380-F for family member). Be familiar with these forms and when they're appropriate versus a simple excuse note.
7. Frequently Asked Questions
What should be included in a doctor's excuse note?
A valid doctor's excuse note must include: practice letterhead with contact information, patient's full name and date of birth, date of examination, dates the patient should be excused from work/school, any work restrictions or limitations, physician's signature and credentials, and medical license number. The diagnosis is NOT required and should generally be omitted for privacy.
Can my employer call my doctor to verify a medical excuse?
Yes, employers can call to verify the authenticity of a doctor's note, but HIPAA limits what information the doctor can share. The doctor can confirm they issued the note and the dates, but cannot disclose your diagnosis or medical details without your written consent. Employers cannot ask about your specific medical condition.
Is a doctor's note required for FMLA leave?
Yes, for FMLA leave employers may request medical certification within 15 calendar days. However, the FMLA does not require you to disclose your specific diagnosis. The certification must verify a serious health condition exists and its expected duration. Employees who fail to provide certification may have FMLA leave denied.
What are the consequences of using a fake doctor's note?
Using a fake doctor's note is illegal and can result in immediate termination, criminal fraud charges, damage to professional reputation, and difficulty finding future employment. Employers can verify notes by calling the medical practice, checking medical license databases, and using digital verification services. Once trust is broken, it is very difficult to rebuild.
How long can I be excused from work with a doctor's note?
The duration depends on the medical condition and employer policy. FMLA provides up to 12 weeks of unpaid, job-protected leave for eligible employees. For shorter absences, company sick leave policies vary. The ADA may require additional leave as a reasonable accommodation beyond FMLA if you have a disability, unless it causes undue hardship to the employer.
Does a doctor's note have to include a diagnosis?
No, a doctor's note should NOT include a specific diagnosis due to HIPAA privacy protections. The note should only state that the physician examined the patient on a certain date and the dates the patient should be excused. Including detailed medical information risks violating patient confidentiality laws. Employers cannot legally require a diagnosis for standard sick leave.
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