Administrative — School Excuse Note Template
The School Excuse Note Template is designed for physicians and healthcare providers completing documentation to excuse student absences from school for medical reasons. This template provides a simple, standardized format for school excuse notes while maintaining appropriate medical documentation. The template includes sections for student and school information, dates of absence, reason for absence, and provider attestation. This template streamlines the school excuse process, ensures clear communication with schools, supports student attendance policies, and protects provider time by standardizing documentation. The structured format is adaptable for various medical conditions causing school absence. Ideal for pediatric practices, family medicine practices, and practices frequently completing school excuse notes.
Template
Note Header
Provider name, credentials, practice name
Address, phone
Date
Student Information
Student name, DOB
School: [School name]
Grade: [If known]
Absence Information
Dates absent: [Start date] to [End date]
Reason: [Medical reason for absence]
Return date: [Date student may return]
Provider Attestation
I certify that the above student was under my care and unable to attend school for the dates specified above due to [medical condition].
Provider Signature
[Signature, credentials, date]
💡 Tip: Click anywhere to edit. Changes are temporary.
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