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Medical Sick Certificate

Medical Sick Certificate Template for Netherlands

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Key Requirements PROMPT example:

Medical Sick Certificate

"I need a Medical Sick Certificate for an employee who will be absent due to illness from January 15, 2025, for an expected duration of one week, including standard privacy clauses and basic return-to-work conditions as per Dutch requirements."

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Document background
The Medical Sick Certificate is a crucial document in the Dutch employment and healthcare system, required when an employee needs to formally document their medical inability to work. This certificate is designed to meet the requirements of Dutch legislation, including the Working Conditions Act and privacy regulations (GDPR/AVG). It provides official confirmation of an employee's need for sick leave while carefully balancing the employer's need for information with the patient's right to medical privacy. The Medical Sick Certificate typically includes duration of incapacity, work limitations, and authentication by a qualified medical professional, without disclosing specific medical conditions. It serves as a key document for sick leave administration, insurance claims, and compliance with Dutch employment law.
Suggested Sections

1. Certificate Header: Official letterhead of the medical practice/hospital, including registration numbers and contact details

2. Patient Information: Basic identifying information of the patient (name, date of birth, ID number) - minimal required information to comply with privacy regulations

3. Medical Professional Details: Name, professional registration number (BIG-nummer), and qualification of the issuing medical professional

4. Certificate Statement: Formal statement confirming the medical examination and sick leave requirement

5. Duration of Incapacity: Specified period of sick leave, including start date and expected return date if applicable

6. Work Capacity Assessment: General indication of work capacity limitations without disclosing specific medical details

7. Authentication: Date, signature of the medical professional, and official stamp of the medical facility

Optional Sections

1. Work Restrictions: Specific work-related restrictions or modifications, included when partial work capacity is possible

2. Follow-up Requirements: Details of required follow-up appointments or reassessments, included when ongoing monitoring is necessary

3. Referral Information: Information about referrals to specialists or additional treatments, included when relevant to the sick leave period

4. Gradual Return Plan: Structured plan for returning to work gradually, included when applicable for longer-term absences

Suggested Schedules

1. Privacy Notice: Standard appendix explaining how the medical information will be handled in accordance with GDPR/AVG

2. Patient Rights Information: Document outlining the patient's rights regarding the sick certificate and medical information

3. Employer Communication Guidelines: Instructions on how the certificate should be shared with the employer while maintaining medical privacy

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓƵ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
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Relevant Industries

Healthcare

Education

Manufacturing

Professional Services

Retail

Information Technology

Financial Services

Construction

Transportation

Public Sector

Hospitality

Energy

Telecommunications

Agriculture

Relevant Teams

Human Resources

Medical Administration

Occupational Health

Compliance

Legal

Payroll

Benefits Administration

Employee Relations

Operations Management

Relevant Roles

HR Manager

HR Business Partner

Benefits Administrator

Occupational Health Physician

General Practitioner

Medical Administrator

Compliance Officer

Privacy Officer

Employee Relations Manager

Absence Coordinator

Payroll Specialist

Office Manager

Department Manager

Line Manager

Industries






Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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