McKesson Clinical Reference Systems: Women's Health Advisor 2002.2

 
Name_____________________________  needs to be excused from 

work / school / physical education for the following dates: 

___________________________________________________________.  


He / she may return to work / school but still avoid physical 

activity as of this date:__________________________________.  


He / she may return to full physical activity as of this date: 

___________________________________________________________.  



Additional comments / instructions:_________________________ 

____________________________________________________________ 

___________________________________________________________.  







____________________________________________________________ 
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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.