medical certificate format for school leave

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Home > Letter Samples > Leave Letters > Medical Leave Letter from Doctor Sample
Letter Samples

Medical Leave Letter from Doctor Sample

  • Leave
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Alfonzo Lopez, M.D.

100 Broadway Lane, New Parkland, CA, 91010

Cell: (555) 987-1234

[email protected]

Dear Ms. Ross,

I am writing on behalf of David Graham, my patient and your employee. I am requesting that you grant Mr. Graham a medical leave of absence from his work at Oceanside Corporation due to a confirmed case of laryngitis coupled with swelling of the throat and extreme irritation. I recommend at least 4 days off from work to allow Mr. Graham to completely recover from this condition.

Since Mr. Graham works in a position where he is in frequent contact with other employees, I feel it is necessary to ensure a complete recovery before he returns to work. I will be seeing my patient for a follow-up visit on September 25, 2014. I will fully assess his condition at that point and send you a copy of my assessment in writing following the visit for your HR records.

Barring any complications, I expect Mr. Graham to make a full recovery within a relatively short period of time since he is otherwise healthy with no significant medical issues. Please feel free to contact me or my office staff if you need further clarification or documentation concerning this medical leave letter. Thank you kindly for your prompt attention to this matter.


Alfonzo Lopez, M.D.

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