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Doctors Note Example For Student

This doctor's note template confirms that an individual was examined in the offices of Dr. David Lee and Dr. Maria Lopez and may return to work or school on a specified date with certain medical restrictions. The template includes fields for the patient's name, return date, and restrictions. It notes that the document is not valid unless signed by a licensed medical professional and provides the license terms for personal use of the template.

Uploaded by

Hugo Castillo Gonzalez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
4K views2 pages

Doctors Note Example For Student

This doctor's note template confirms that an individual was examined in the offices of Dr. David Lee and Dr. Maria Lopez and may return to work or school on a specified date with certain medical restrictions. The template includes fields for the patient's name, return date, and restrictions. It notes that the document is not valid unless signed by a licensed medical professional and provides the license terms for personal use of the template.

Uploaded by

Hugo Castillo Gonzalez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
  • Medical Release Template: A document confirming medical examination status with space for signature and date to authorize return to work or school.
  • License Terms & Conditions: Outlines the licensing terms for using the provided document templates, including restrictions and legal notes.

444 Centre Ave, Newark NW 32458

PH: 999.888.7777 FX:999.888.7777


Dr. David Lee, M.D. | Dr. Maria Lopez, M.D.

15-Dec-2015

TO WHOM IT MAY CONCERN

This document is to confirm that:

_________________________________ was examined in our offices and may return to work


or school on ______/_______/20___, under the following medical restrictions:

X________________________________
Dr. Maria Lopez, M.D.

-------------------------------------------------------------------------------------------------------------------------------- 54554-G

This document is not valid unless signed by a licensed medical professional.


[Link] LICENSE TERMS & CONDITIONS

________________________________________

You are free to use the downloaded templates for personal uses.

You are not allowed to redistribute this file in any manner unless otherwise you have a written consent.

Any template linked in your website / any online or print medium should be duly attributed with
Creative Common 3 license before you do so.

Check other attractive templates from [Link]

Please note - this document is provided only for educational / entertainment use only.
[Link] is not responsible for any kind of misuse of this document. The hospital names,
doctor names and doctors signatures (if any) shown in the doctor note templates are purely a work of
art and fiction. Any real life co-incidence with real hospitals / medical centers / doctors are
unintentional co-incidence only.

Thanks!!!

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