Sick note template for clinicians
A sick note is a short document with long consequences for the patient's job and income. It should state what you assessed and for how long the patient is unfit, and nothing an employer does not need. Here is a neutral template, an invented example, common errors, and how ClearPass drafts a sick note from the visit.
What a sick note should contain
Rules on what a medical certificate must contain differ between countries and sometimes between employers or schools. Some places require a specific official form. This template is a general layout, not a legal form; check your local requirements before you sign.
Within those rules, most sick notes include: the date you assessed the patient, whether the assessment was in person or remote, a statement that in your opinion the patient is not fit for work (or fit with adjustments), the period covered with start and end dates, the minimum diagnosis wording needed, and your name, role, contact details and signature. Diagnosis wording should be agreed with the patient. Many clinicians use a general term such as a medical condition or an acute illness when the specific diagnosis is not needed by the reader.
Blank sick note
MEDICAL CERTIFICATE - FITNESS FOR WORK
Clinic: [name, address, contact]
Date of assessment: [ ] Type: [in person / remote]
I assessed [patient identifiers as required locally] on the date above.
In my opinion this person:
[ ] is not fit for work
[ ] may be fit for work with the following adjustments:
[reduced hours / altered duties / workplace adaptations / phased return]
Period: from [date] to [date] inclusive
Condition (wording agreed with patient): [ ]
Review needed: [yes, date / no]
[Name, role, professional registration if required]
[Signature] Date issued: [ ]
Leave the period blank rather than guessing if the dates were not agreed during the visit.
Filled example: acute gastroenteritis
MEDICAL CERTIFICATE - FITNESS FOR WORK Date of assessment: [date] Type: in person I assessed the patient on the date above. In my opinion this person is not fit for work. Period: 3 days, from [date of assessment] to [date + 2 days] inclusive. Condition: acute gastrointestinal illness. Review needed: no, unless symptoms persist beyond the period stated. Note: the patient works as a food handler and has been advised about returning only once symptom-free for the period required by the workplace. [Name, role] [Signature]
The matching clinical note would hold the details: two days of vomiting and diarrhoea, mild dehydration, oral fluids advised. The certificate does not repeat them.
Errors on sick notes
- More diagnostic detail than the reader needs, or detail the patient did not agree to share.
- Backdating without saying so. If the period starts before your assessment, state that it is based on the patient's account.
- An open-ended period with no review date.
- Ticking not fit when a phased return or lighter duties would have been possible and wanted.
- Signing a template you did not read line by line.
How ClearPass drafts a sick note
From the visit note, choose Sick note in Documents or in the Ask box. ClearPass writes a short sick note or fitness-to-work note based only on what was documented, keeping the diagnosis wording minimal and appropriate for an employer. If the period of leave is not stated in the note, it leaves a clearly marked blank for you to fill. You can also type the dates in the extra detail box, for example 3 days off from today.
ClearPass does not know your local form or the legal wording your country requires, and it does not fill official forms. Treat the draft as the text to transfer onto whatever your service uses, check the dates and wording, and sign it only after review. For school or travel letters, see the fitness letter template.
What ClearPass does not do
- It does not replace your judgement. Every note is an AI draft that you review and correct before it is used.
- It is not a medical device and does not make clinical decisions. It is a documentation aid.
- It does not connect to your EMR. The note is copy-ready text that pastes into any system.
Privacy
Clinical note content is not stored on ClearPass servers: it is processed to write the note, then discarded. Consultation audio is transcribed and discarded, never stored. Your note history stays in your browser, on your device, and you choose how long it is kept. Common identifiers are removed from typed and transcribed text before it reaches the AI; that is a best-effort safeguard, so leave names, ID numbers and file numbers out where you can. Processing goes through the AI providers named in our Privacy Policy, which sets out exactly what each one receives and how long it keeps it. ClearPass does not sign HIPAA business associate agreements today.
Questions
Should I put the exact diagnosis on a sick note?
Only if it is needed and the patient agrees. A general description is often enough for an employer. Local rules may say what is required.
Can I issue a sick note after a phone or video visit?
That depends on the rules where you practise. If you do, state on the note that the assessment was remote.
Does ClearPass produce an official certificate?
No. It drafts the wording. You check it against local requirements, transfer it to the form your service uses if there is one, and sign it.
What does ClearPass cost?
The 7-day trial is free, needs no card and simply ends after 7 days, with no automatic charge. After that there is one plan: $78 a month or $858 a year, with every visit transcribed.
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