Doctor's Note Template with Examples

Canadian sick-note reality

Several Canadian medical regulators and the CMA have discouraged routine sick notes for brief, self-limited absences. The argument is workload and access: a person with a 48-hour viral illness should not occupy an appointment that another patient needs, and a note written without an assessment is not a clinical document. Confirm the current college position in your province, and your clinic's policy, before you refuse or issue one.

CPSO-style guidance in Ontario has treated short-absence notes as an administrative demand that often does not require a visit. Other colleges have published similar directions. Employers and schools still ask. When you do write a note, you are certifying that you assessed the patient (in person, virtually, or by a clinically justified chart review of an ongoing condition) and that the restriction is honest.

What to put on the page

Letterhead, date of the letter, date of the assessment, patient identifiers, the period of absence or restriction, and your name plus college number. Functional language beats diagnostic language. 'Unable to lift more than 5 kg, no repetitive gripping, desk work allowed, review in 14 days' is usable by a supervisor. 'Wrist problem' is not.

Privacy: PHIPA and provincial equivalents still apply. Many patients do not want a diagnosis on a note that will sit in an HR file. Ask. If they want the diagnosis on the page (some insurers and some schools insist), document that consent in the chart. Do not include HIV status, pregnancy, mental-health diagnoses, or substance-use detail unless the patient explicitly asked and it is required for the purpose of the letter.

Duration should match the condition you assessed. A culture-positive strep throat with fever today can support a few days off. It cannot support six weeks off. If the course is uncertain, write a short window and a reassessment date rather than an optimistic or punitive end date. If work is the injury (WSIB / WorkSafe), the sick note is the wrong form; complete the provincial report and a functional abilities form.

Example 1 — work absence

Riverside Family Practice
120 Queen St S, Mississauga ON  |  905-555-0142
Date: 12 March 2026

To: Occupational Health, City Transit

Re: Jordan Hale, DOB 4 June 1991

I assessed this patient in clinic on 12 March 2026. They have an acute influenza-like illness with fever and are unfit for safety-sensitive work (driving) from 12 March 2026 to 16 March 2026 inclusive.

They may return to full duties on 17 March 2026 if fever-free for 24 hours without antipyretics. No modified duties are required after that date. Diagnosis omitted at the patient's request.

Sincerely,
Dr. A. Rahman, CCFP
CPSO # 123456

Example 2 — school absence

Dalhousie Student Health
Halifax NS  |  902-555-0194
Date: 8 April 2026

To: Faculty of Science, exam deferral office

Re: Priya Nair, DOB 19 November 2005
Student number:  on file with the student

I assessed this student on 6 April 2026 and reviewed them virtually on 8 April 2026. They have an acute migraine cluster that began 5 April 2026, with photophobia and vomiting, and were unable to attend classes or sit an examination on 7–8 April 2026.

They are medically unfit to write the 8 April 2026 midterm. They should be well enough to sit a deferred exam after 11 April 2026. No ongoing academic restrictions are recommended after that date. Diagnosis included with the student's consent.

Sincerely,
Dr. L. Chiasson, CCFP
CPSNS # 654321

Example 3 — modified duties

Prairie Avenue Clinic
Regina SK  |  306-555-0177
Date: 3 February 2026

To: Store manager / occupational health

Re: Michel Tremblay, DOB 22 August 1979

I assessed this patient on 3 February 2026. They have an acute right lateral elbow tendinopathy related to repetitive scanning.

They may work from 4 February 2026 with the following temporary restrictions, to be reviewed on 17 February 2026:
- No repetitive gripping or scanning with the right hand
- No lifting more than 2 kg with the right arm
- Left-handed or two-person till work, bagging, or customer-service desk is acceptable
- Full duties not expected before review

This is not a workplace-injury form. If the employer considers this a compensable injury, please route through the provincial workers' compensation process. Diagnosis included with the patient's consent.

Sincerely,
Dr. S. Okonkwo, CCFP
CPSS # 778899

Mistakes that show up in letters

• Issuing a note without an assessment (including 'just this once' for a relative).
• Back-dating a long absence you first heard about today, as if you had followed them throughout.
• Putting a psychiatric or infectious diagnosis on an HR letter the patient did not agree to share.
• Open-ended 'off work until further notice' with no review date.
• Vague restrictions ('light duties') that a supervisor cannot operationalize.
• Using a sick note instead of a WSIB Form 8, WorkSafe report, or functional abilities form.
• Signing a generated letter that still has placeholder brackets.

CMPA files on certificates often turn on honesty of the assessment and clarity of the dates. Colleges treat false or undocumented notes as integrity issues, not paperwork slip-ups. If an employer demands a diagnosis you should not share, write function only and offer to speak with occupational health with the patient's consent.

Sick note vs medical certificate

A doctor's note is usually a short absence or modified-duties letter for work or school. A medical certificate is the longer fitness document (return-to-work, EI sickness, sports clearance, third-party insurer). If the ask is fitness, duration of disability, or a named form, use a certificate, not a three-line sick note.

Frequently asked questions