Certification of Health Care Provider for Employee's Serious Health Condition

A Certification of Health Care Provider is a form completed by a healthcare professional that verifies an employee’s serious health condition. It provides details about the medical issue, how it affects the employee’s ability to work, and the expected duration of leave. Employers use this form to confirm the need for time off under laws like the Family and Medical Leave Act (FMLA). It ensures the leave is justified and helps both parties plan for the employee’s recovery and return to work. The form respects patient confidentiality while providing essential information for job protection.