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Sick Note


Example of a sick note that can also double as a general note or referral letter.
 




This is to confirm that Prof / Dr / Mr / Mrs / Ms / Miss / Mast


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Has been under my care from the / examined by me on the:
Has been under the care / examined by my associate on the:


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Suffering from / relating to / reported to have had


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and that he / she...

  • Will be fit to resume work / school / duty on the:
  • Was too ill to write his / her exam on the:
  • Is in good health and free of contagious diseases
  • Is in good health and may travel by plane
  • Is in good health and may go scuba diving
  • Is in good health and fit for employment
  • Is in good health and may go motor racing
  • Has a medical condition that requires the following travelling arrangements:
  • Is currently taking the following prescription medication:
  • Needs to be referred to the following therapist / specialist:
  • May only resume sport / physical training / on the:
  • None of the above, but with the following recommendations:
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