Family Medicine Template

Sick Notes-Mental Health Condition

A professional Family Medicine template for healthcare professionals.

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  • OVERALL_INSTRUCTIONS

  • Chief Complaint

    Temporary adjustment to work schedule due to mental health condition

  • Template

    Medical Recommendation – Temporary Adjustment to Work Schedule To Whom It May Concern, I am writing in my capacity as [position_title] for my patient, [patient_name], whom I am currently supporting for a mental health condition. I recommend a temporary adjustment to [her/his/their] working arrangements, specifically working [four (4)]days per week for a period of [six (6)] weeks, effective from the week of [date]. This recommendation is made to allow assessment and management of work-related anxiety symptoms that reliably emerge during mid-to-late week shifts (particularly Wednesday and Thursday). These symptoms have been a contributing factor to occupational burnout, and a short-term reduction in workload is clinically appropriate to support recovery while maintaining work engagement. [patient_name] is actively engaged in treatment, including regular appointments with a psychologist, and is demonstrating insight and commitment to her care plan. This adjustment is intended to be time-limited and therapeutic, with review at the end of the six-week period. Importantly, I assess that she has the capacity to proceed with her performance review, which has been previously delayed. Participation in this process is not contraindicated from a medical or psychological standpoint. Please note that this recommendation is made without disclosure of detailed medical information, in the interest of maintaining patient confidentiality. Should you require confirmation of this recommendation, I can be contacted at the details below. Kind regards, [doctor_name] [qualifications] [practice_name] [contact_details]

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This comprehensive new patient template helps establish care by capturing complete medical history, current concerns, and baseline health status. Use this for patients during their initial visit to create a thorough medical record.

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