Miscellaneous.Practice Letterhead

Treating Doctor.Name
Treating Doctor.Qualifications
Treating Doctor.Address
Treating Doctor.Suburb  Treating Doctor.Postcode

Medical Certificate

This is to certify that Patient Demographics.Title Patient Demographics.First Name Patient Demographics.Surname is receiving medical treatment and for the period 

From Date	TO	To Date	INCLUSIVE
		      
Patient Demographics.He/She will be unfit to continue Patient Demographics.his\her  usual occupation.

Patient Demographics.Full Name does not meet the clinical criteria for testing for COVID-19 and as such the patient will be fit to return to work on the above stated date

This Certificate was completed on Miscellaneous.Date.  

Treating Doctor.Name

Treating Doctor.Provider Number