Doctor's Excuse for Physical Education
Doctor’s Excuse for Physical Education
Date: September 12, 2058
To Whom It May Concern,
Student Name: Allene Tillman
DOB: January 22, 2042
Student ID: 45678
Provider: [Your Name]
Specialty: Sports Medicine
Facility: [Your Company Name]
Contact: [Your Company Email] | [Your Company Number]
Reason for Excuse: Ankle Sprain
Summary of Visit:
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Diagnosis: Allene Tillman was evaluated on September 10, 2058, for an ankle sprain sustained during a sports activity. The injury is characterized by swelling, bruising, and limited range of motion.
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Treatment: Allene has been prescribed rest, ice application, and elevation of the affected ankle. She is also advised to use a supportive brace and avoid weight-bearing activities.
Physical Education Excuse Details:
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Excuse Period: Allene is excused from participating in physical education classes from September 10, 2058, through September 24, 2058. During this period, she should refrain from any physical activities that may exacerbate her injury.
Follow-Up Care:
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Next Appointment: Allene is scheduled for a follow-up visit on September 20, 2058, to assess the healing process and adjust the treatment plan as necessary.
Sincerely,
[Your Name]
Primary Care Physician
