The Medical Certificate For Sick Leave Template – Australia is provided in multiple formats, including PDF, Word, and Google Docs. These files are both customizable and ready for printing, making it easy for you to meet your requirements.
Medical Certificate For Sick Leave Template – Australia Editable | PrintableSample
1. Patient Information 2. Medical Practitioner Information 3. Medical Diagnosis 4. Leave Recommendation 5. Return to Work Date 6. Additional Notes 7. Signature and Declaration
PDF
WORD
Examples
[Doctor’s Name]
[Practice Name]
[Clinic Address]
[City, State, Zip Code]
[Phone Number]
[Email Address]
[Patient’s Name]
[Patient’s Date of Birth]
[Patient’s Address]
[Date of Issue]
This is to certify that the above-mentioned patient has been examined and is under my care.
[Diagnosis – Brief Description]
The patient is advised to take a leave of absence from work due to the condition mentioned above, starting from [Start Date] to [End Date].
It is recommended that the patient engages in appropriate rest and/or treatment during this period, and they may require follow-up consultation after [Follow-up Date].
This certificate is valid for the purpose of sick leave and is issued in accordance with Australian medical guidelines.
[Doctor’s Signature]
[Printed Name of the Doctor]
[Qualifications & Registration Number]
[Doctor’s Name]
[Practice Name]
[Clinic Address]
[City, State, Zip Code]
[Phone Number]
[Email Address]
[Patient’s Name]
[Patient’s Date of Birth]
[Patient’s Address]
[Date of Issue]
This certificate confirms that the patient named above is currently experiencing medical issues.
[Condition – Detailed Description]
The patient should not report to work from [Start Date] until [End Date] to facilitate recovery.
The patient is advised to rest and adhere to prescribed treatment during this period, with a potential follow-up consult on [Follow-up Date].
This certificate serves as formal documentation for employer purposes as per the relevant Australian regulations.
[Doctor’s Signature]
[Printed Name of the Doctor]
[Qualifications & Registration Number]
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