Common use of Certification by Physician Clause in Contracts

Certification by Physician. Describe the serious health condition31giving rise to the request by the employee for extended sick leave. Date the serious health condition commenced/will commence. Probable duration of the serious health condition (approximate date of return to work). Medical facts, including the recommendation of the physician, concerning continuation in the current work assignment. Print/Type Name of Physician Signature of Physician Date Please return to: Office Of The Business Manager Community High School Dist. 000 0000 Xxxx Xxxx Xxxx Lake Villa, IL 60046

Certification by Physician. Describe the serious health condition31giving rise to the request by the employee for extended sick leave. Date the serious health condition commenced/will commence. Probable duration of the serious health condition (approximate date of return to work). Date the serious health condition commenced/will commence. Medical facts, including the recommendation of the physician, concerning continuation in the current work assignment. Print/Type Name of Physician Signature of Physician Date Please return to: Office Of The Business Manager Community High School Dist. 000 0000 Xxxx Xxxx Xxxx Lake Villa, IL 60046

Certification by Physician. Describe the serious health condition31giving condition1giving rise to the request by the employee for extended sick leave. Date the serious health condition commenced/will commence. Probable duration of the serious health condition (approximate date of return to work). Medical facts, including the recommendation of the physician, concerning continuation in the current work assignment. Print/Type Name of Physician Signature of Physician Date Please return to: :Office Of The Business Manager Community High School Dist. 000 0000 Xxxx Xxxx Xxxx Lake Villa, IL 60046

Certification by Physician. Describe the serious health condition31giving condition1giving rise to the request by the employee for extended sick leave. Date the serious health condition commenced/will commence. Probable duration of the serious health condition (approximate date of return to work). Date the serious health condition commenced/will commence. Medical facts, including the recommendation of the physician, concerning continuation in the current work assignment. Print/Type Name of Physician Signature of Physician Date Please return to: Office Of The Business Manager Community High School Dist. 000 117 0000 Xxxx Xxxx Xxxx Lake VillaXxxx Xxxxx, IL 60046XX 00000