MEDICAL CERTIFICATE FOR EMPLOYEES AND STUDENTS Patient name DOB
Your Employee/Student has presented for a COVID-19 swab. They are symptomatic and meet the HIS (high index of suspicion) criteria as defined by the MOH They must remain off work/school until well and a negative swab result has been reported They are symptomatic and do not meet the HIS (high index of suspicion) criteria as defined by the MOH They must remain off work/school until well. The swab result does not need to be available before they return to work/school They are asymptomatic and the swab was taken as part of a surveillance program They can continue to work/attend school whilst waiting for the swab result unless specifically advised otherwise by a Medical Officer of Health Your Employee/Student is symptomatic, does not meet the does not the HIS (high index of suspicion) criteria as defined by the MOH and is unable to be swabbed/has declined a swab. They must remain off work/school until well
Your Employee/Student does not require a COVD-19 swab as they are not symptomatic or part of a planned surveillance/contact tracing program
Employees and Students who have been symptomatic do not require another medical certificate or review prior to returning to work or school once they are well.
Signed Date Practice Details/Stamp
BOPDHB Medical Certificate Covid-19
Version 1.2
31.8.20ci