Philippine government employees use CSC Form No 41 – the Philippine Civil Service Medical Certificate to support applications for sick leave or maternity leave. A licensed physician fills out this official document to confirm the diagnosis, treatment, and the period when the employee was unable to work, and agencies attach it to the employee's leave papers.
The form typically shows:
✔️ Employee's full name, position, agency, and office.
✔️ Date and place of medical examination.
✔️ Diagnosis or nature of illness, injury, or pregnancy.
✔️ Inclusive dates when the employee was advised to rest.
✔️ Physician's PRC license number and signature certifying medical findings.
✔️ Employee's waiver of physician-patient confidentiality for civil service leave review.
It gives HR offices a standard medical certificate to verify that an absence meets civil service leave rules. For other Philippine civil service forms, see the CSC Form 1 and Civil Service Form 55-B also available on FormsPal.
Note: The Civil Service Commission later replaced this form for most leave applications. Employees now use CS Form 6 (Application for Leave) and attach a regular medical certificate from a licensed doctor. However, some agencies and school divisions still accept the certificate for compliance purposes.
| Question | Answer |
|---|---|
| Form Name | Csc Form No 41 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | form 41 for maternity leave, csc form 41 medical certificate 2020, csc form 41, form 41 |