UNIVERSITY VILLAGE MEDICAL CLINIC

MEDICAL NOTE

To Whom It May Concern:

This is to certify that:  

  • States that he/she was unable to work/attend school for medical reasons on the dates indicated below.
  • Was seen at my office today for medical reasons
  • May return to work
  • May return to suitable work with the following restrictions
  • Was absent due to illness/death in the family
  • No gym or sports for medical reasons for the dates indicated below

From: To: INCLUSIVE

Dated: