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Work Excuse for Parent


Name of patient _________________________________________________

Diagnosis _______________________________________________________ 

Name of parent __________________________________________________ 

This patient had a medical visit today with me at ______________.  
Please take this into consideration when reviewing the parent's 
time away from work.  

Physician's name __________________________________________________

Physician's signature ___________________________ Date ____________

Physician's office phone number ____________________________
Published by McKesson Provider Technologies.
Last modified: 1997-04-01
Last reviewed: 2002-06-08
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
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