Free Doctor Note Template
Doctor Note
To Whom It May Concern,
This is to certify that , was seen and evaluated at my office on
[Patient's Name]
due to
[MM/DD/YYYY] [brief reason for visit, e.g., flu symptoms, back pain etc.]
I have advised that the patient
[should refrain from work/school/daily activities]
from to to allow for proper rest and recovery.
[Start Date] [End Date]
If further accommodations or verification are required, please feel free to contact my office.
Sincerely,
[Doctor’s Name, M.D.]
[Medical License Number]
[Doctor’s Signature]
