Cross Timbers Community Health Center Doctor Excuse Slip

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?

1. Specify the date this document was created.
2. Enter the patient's full name, the appointment's date and time, and the visit's purpose.
3. Print the date the client can return to work (as advised by the doctor) and the number of days they will need to recover.
4. 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.
5. The attending physician who performed the procedure must certify the document with their signature.
6. 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