Medical Excuse Form PDF Details

Doctor, I can't come in to work today. I have a fever and chills. My throat hurts and my chest feels tight. I don't think it would be wise for me to leave the house. If you've ever been ill enough that you couldn't go to work, you know how important it is to have a doctor's note excusing you from duty. For most people, a simple note will do the trick; but what if you're a federal employee or military member? In those cases, your supervisor will likely want something more official-looking than a handwritten note from your doctor.

The listing contains details about the medical excuse form. You'll have the likely time you may need to prepare the form as well as extra details.

Form NameMedical Excuse Form
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesprintable doctors note, printable doctors excuse, doctors excuse for work from hospital, doctors excuse for work

Form Preview Example


Date __________________________

Student’s Name ____________________________________

The above named students has been excused from school for an appointment with your office. Please complete the following and have the student return it to school. This form can also be

faxed to 278-3624.

Thank you for your cooperation.


Attendance Office

* * * * * * * * * * * * * * * * * * * * *

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Please print or stamp doctor’s name and facility location.

Approximate Time Arrived at Office


Approximate Time Left Office


Doctor’s Office Signature ________________________________________________

Watch Medical Excuse Form Video Instruction

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