Quebec form
Quebec Medical Certificate (SR-0040)
SR-0040 is a Quebec medical certificate. Employers, insurers, and schools ask for it to document that you saw the person and that an absence or limitation is medically founded. It is not a CNESST attestation and not a SAAQ driver report. It is a short statement of period, capacity, and diagnosis at the level of detail the form — and privacy — allow.
What SR-0040 is for
The patient usually brings the PDF or a clinic prints the current SR-0040. Complete the version in front of you. If an employer invented its own 'medical certificate' with twenty diagnostic checkboxes, that is a different document. You can refuse fields that demand a diagnosis the patient has not authorized.
Quebec privacy practice is tight on diagnosis disclosure to employers. Many certificates support a period of incapacity and a return date without a disease name. If SR-0040 asks for diagnostic and the patient wants it included, write it. If the patient does not, say 'médicalement justifié' and the dates, and leave diagnosis off.
This is not a lésion professionnelle file
A work accident in Quebec belongs on a CNESST attestation. Using SR-0040 instead under-documents the claim. A non-work gastroenteritis or a migraine week belongs here.
Who signs
A physician or, where the current form and your ordre allow, another professional who assessed the person. Do not sign a certificate for a colleague's patient you have not seen unless you reviewed the chart and the form lets you say that — and even then, it is a weak file.
How to complete it
- Identity as on the RAMQ card. A nickname that does not match payroll will bounce.
- Date of the exam (today), not the date the employer asked for the note.
- Période d'absence or of limitation: start and end. Open-ended 'until further notice' forces another certificate next week anyway.
- Capacité: arrêt complet, retour progressif, or specific limitations (no night shift, no lifting).
- Diagnostic only if the form requires it and the patient agrees. Prefer functional language when the recipient is an employer.
- Your permit number, clinic, and signature. A stamp without a signature is not enough.
If you are certifying a past absence you did not witness, say that the history is consistent and that you did not examine them on those dates. Back-dating an exam you did not do is a college problem.
Worked example (fictional)
Short work absence — infectious illness
Fictional 26-year-old. Do not copy into a real SR-0040.
Exam: 28 août 2026, clinique sans rendez-vous. Période: inapte au travail du 26 au 30 août 2026 inclusivement. Retour prévu 31 août, tâches habituelles. Motif (employeur, sans diagnostic détaillé, consentement limité): maladie aiguë médicalement constatée, fièvre et déshydratation, contagiosité possible jusqu'au 30 août. Pas de limitation résiduelle prévue. Pas un dossier CNESST. Permis, clinique, signature manuscrits.
Why employers reject the certificate
- No end date.
- Certificate dated today for a three-week absence last month with no explanation.
- Diagnosis dumped onto an employer form the patient did not want shared.
- Wrong person: you signed for a spouse who was not in the room.
- Using SR-0040 for a CNESST or SAAQ matter.
Draft SR-0040 from the visit
In Scribeberry, open Forms, search for certificat médical SR-0040, or upload the current official PDF. Generate from the encounter and your notes, then edit every field before you sign. Scribeberry does not pre-map this form. You still review and sign.
Frequently asked questions
Do I have to put a diagnosis on SR-0040?
Only if the form requires it and the patient authorizes that disclosure. For many employer certificates, dates and capacity are enough. When the patient wants the diagnosis included, write it.
Can I certify days before I saw the patient?
You can state that the history is consistent with incapacity from a stated date. You cannot pretend you examined them on a day you did not. Say what you know.
Is SR-0040 billed to RAMQ?
Third-party certificates are often uninsured. Follow the current RAMQ and Fédération des médecins billing rules. This page is not a fee code.
Does Scribeberry send SR-0040 to the employer?
No. Scribeberry helps you complete the PDF. The patient (or you, with their direction) delivers it. Keep a copy in the chart.
Forms
