Steps to Complete This Medical Certificate
Follow these steps to accurately fill out the Philippine Civil Service Medical Certificate:
- Patient Information – Enter the employee's full name, position title, agency name, and official office address in the designated fields at the top.
- Physician's Examination Details – The attending physician records the date and location of the examination, including the name of the hospital or clinic where the employee was seen.
- Diagnosis and Nature of Illness – The physician writes a clear diagnosis covering the specific illness, injury, or pregnancy. For recurring conditions, include a brief history of prior treatment episodes.
- Inclusive Dates of Disability – Indicate the exact dates from when the employee was advised not to report for duty through the expected recovery date. These dates must align with the leave dates on the accompanying leave application.
- Laboratory and Clinical Findings – Summarize relevant laboratory results or clinical observations that support the diagnosis. Attach copies of lab reports if required by the agency.
- Physician Certification – The licensed physician signs and provides their full name, Professional Regulation Commission (PRC) license number, professional address, and contact details.
- Confidentiality Waiver – The employee signs the waiver authorizing the physician to disclose health information to the civil service agency for leave review purposes.
After completing the certificate, attach it to your leave application (Civil Service Form 55-B) and submit both documents to your HR office. You can also explore the CSC Form 1, CSC Form 211, and Medical Certificate for PWD Philippines for related government medical documentation needs.
Frequently Asked Questions
Who fills out the CSC Form No 41 medical certificate?
The attending physician completes and signs the medical sections. The employee only signs the confidentiality waiver. HR officers do not fill in any medical data on this certificate.
Is the civil service medical certificate still used for sick leave?
The Civil Service Commission has updated its leave documentation requirements. Most agencies now accept a regular medical certificate attached to CS Form 6 (Application for Leave). However, certain units, particularly DepEd divisions and some local government agencies, still require or accept this certificate for record-keeping and compliance audits.
How many copies of the medical certificate should be prepared?
Prepare at least two copies: one for the employee's personnel file and one for the HR office. Some agencies request a third copy for their payroll or finance section. Always verify the specific submission requirements with your agency's HR office before submitting.
Can a private physician sign the medical certificate?
Yes. Any licensed physician in the Philippines may complete the form, whether employed in a government hospital or in private practice. The physician must include their PRC license number for the certification to be valid for civil service leave purposes.
What is the difference between this form and CS Form 6?
The CSC Form No 41 is a medical certificate completed by a physician to certify illness or disability. CS Form 6 is the actual application for leave that the employee submits to request approved time off. Both documents are typically submitted together: the employee files CS Form 6 and attaches this medical certificate as supporting evidence of the medical condition.