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Sample Letter to Document Disability From Primary Care Physician To Vocational Rehabilitation www. hrtw. org Date TO NAME OF VR COUNSELOR Office of Rehabilitation Services ADDRESS CITY STATE FROM DOCTOR s NAME its better if this is on the physician s letterhead RE John XXXXXX XXXXXXX Age 18 DOB XX/XX/1986 Phone XXX-XXX-XXXX Graduate of XXXXXX High School as of June 9 2004 Dear NAME OF VR COUNSELOR The purpose of this letter is to document significant chronic health conditions that impair...
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This is where you can create your excuse letter simply by filling in the blanks in this field simply enter in the date of your note here you can select from several facilities or offices that you claim to have been seen by or you can make up your own facility or office name or use one that you know about in your town you can do the same thing with the address of the facility or office that you are using enter your first and last name or the name of the person that will be using the note choose from a list of medically qualified reasons for the excuse letter you can choose any from the list of medical certifications to use with your excuse letter enter the dates you are to be excused finally enter any limitations if any that you may have when you return this is a sample of the excuse note that you will generate notice the letterhead centered above this is the body of the excuse letter that you generated notice for a touch of authenticity that we've included a CC to medical records you print this on your own printer be sure to turn off the footer so a URL or page number doesn't appear at the bottom of your letter