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What is a Cross Timbers Community Health Center Excuse form?
The CTCHC Doctor Excuse Slip is a one-page note that Cross Timbers Community Health Center doctors can write to their patients. It is provided to the workplace as a valid excuse for being absent from work on the day of the appointment, as well as for obtaining a temporary exemption for recovery.
What do I need the CTCHC Excuse Slip for?
- If you are a CTCHC client and have to miss work day (-s) due to a medical appointment, you can request this from the clinic.
- Many employers require a medical note if an employee not only missed one day of work (in whole or in part) but also requested sick leaves for recovery from procedures.
- Non-CTCHC clients should not request this form.
How to Fill Out the CTCHC Excuse Slip?
- Specify the date this document was created.
- Enter the patient's full name, the appointment's date and time, and the visit's purpose.
- Print the date the client can return to work (as advised by the doctor) and the number of days they will need to recover.
- If, after medical procedures, the patient can return to work but must comply with the restrictions, they should also be listed. Also, indicate the period of these restrictions.
- The attending physician who performed the procedure must certify the document with their signature.
- The completed file can be submitted electronically or printed to the employer (or HR department).
Organizations that work with the CTCHC Excuse Slip
- US employers
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Fillable online Cross Timbers Community Health Center Doctor Excuse Slip