KEMBAR78
Doctors Note Excuse Form | PDF | Wellness
Scribd
Upload
3K views1 page

Doctors Note Excuse Form

Samuel A. Goodwin was under a doctor's care on January 30, 20XX and was able to return to school/work on January 31, 20XX. The doctor instructed Samuel to apply Nystatin cream to lesions every 4-6 hours, keep from scratching or other irritations, and keep areas well cleaned. Samuel has a follow-up appointment on February 6. Kristen Hutchison was also under a doctor's care on January 30, 20XX and able to return to school/work on January 31 due to her child's illness.

Uploaded by

Jose A. Garcia Torres
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
3K views1 page

Doctors Note Excuse Form

Samuel A. Goodwin was under a doctor's care on January 30, 20XX and was able to return to school/work on January 31, 20XX. The doctor instructed Samuel to apply Nystatin cream to lesions every 4-6 hours, keep from scratching or other irritations, and keep areas well cleaned. Samuel has a follow-up appointment on February 6. Kristen Hutchison was also under a doctor's care on January 30, 20XX and able to return to school/work on January 31 due to her child's illness.

Uploaded by

Jose A. Garcia Torres
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 1

Doctor's Note Excuse Form

Certificate for school or work:


_Samuel A. Goodwin______________________ was under my care on _January
30, 20XX_____________ he/she will be able to return to school/work
on __January 31, 20XX_________.

Doctors Comments: Apply Rx Nystatin Cream to lesions every 4 to 6 hours. Keep from
scratching or other irritations. Also, keep areas well cleaned to prevent from spreading. Will see
Samuel for follow-up appointment in one week on February 6, 20XX at 10:30 a.m. If any
questions or condition worsens contact doctor immediately._______
______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________

Certificate for school or work:


_Kristen Hutchison ______________________ was under my care on _January
30, 20XX_____________ he/she will be able to return to school/work
on January 31, 20XX___________.
Doctors Comments: Kristen was unable to attend work due to the illness of her child .
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________

You might also like