The Centrelink Approved Medical Certificate Template – Australia is provided in multiple formats, including PDF, Word, and Google Docs. Each version is both customizable and suitable for printing, ensuring they cater to your requirements effortlessly.
Centrelink Approved Centrelink Medical Certificate Template – Australia Editable | PrintableSample
1. Patient Information 2. Medical Practitioner Information 3. Medical Condition 4. Duration of Condition 5. Recommendations for Work 6. Additional Remarks 7. Certification 8. Signature and Date
PDF
WORD
Examples
[Patient’s Name]
[Patient’s Address]
[Patient’s Phone]
[Patient’s Date of Birth]
[Doctor’s Name]
[Doctor’s Qualifications]
[Doctor’s Address]
[Doctor’s Phone]
[Date of Issuance]
The patient has been diagnosed with [medical condition] and is under my care.
The patient has presented with [detailed medical history related to the condition] which has necessitated a period of absence from work/education.
It is advised that the patient take leave from [Start Date] to [End Date] to ensure proper recovery.
The patient will require a follow-up appointment on [Follow-Up Date] to assess recovery and determine fitness to return to work/education.
[Doctor’s Signature]
[Doctor’s Name]
[Date]
[Patient’s Name]
[Patient’s Address]
[Patient’s Phone]
[Patient’s Date of Birth]
[Doctor’s Name]
[Doctor’s Qualifications]
[Doctor’s Address]
[Doctor’s Phone]
[Date of Issuance]
This certificate confirms that the patient has been diagnosed with [medical condition].
In connection with the medical condition, the patient has shown symptoms such as [list symptoms] which significantly affect their ability to [list affected functions like work or study].
I recommend a leave period starting from [Start Date] through to [End Date] to ensure adequate recovery time.
The patient is expected to be fit to return by [Expected Return Date], subject to ongoing assessment of their condition.
[Doctor’s Signature]
[Doctor’s Name]
[Date]
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