Free Printable Doctor’s Note for Work

274 Grant Lane

Grand Rapids, MI 49503
Phone: 231-234-1587
Fax: 231-234-1588

PATIENT INFORMATION:

Name: __________________________ Gender ___________________

Age: __________ Weight: ________________ Height: ___________________

Symtoms:
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
____________________

Dear Mr. / Mrs. _____________________;

Please excuse _______________ from work for _____ days,due to the current medical issues they are experiencing.

Diagnosis:
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
______________________________

Prescription:
__________________________________________________________________
__________________________________________________________________
________________________________

Regards,

__________________________
 WARNING:
This document is for novelty purposes only. This document does not contain most of
the elements that are seen in real doctor’s notes. For accurate, highly-realistic
doctor’s notes, do not use this note or any free documents found on the internet.
Instead we highly recommend purchasing your documents from
bestfakedoctorsnotes.net.