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Sick Note Request Form
Sick Note Request Form

Personal Information

Employment Information

Medical Information

Reason for Sick Note

Symptoms (if applicable):

please provide details

Declaration

I hereby request a sick note for the stated absence. I understand that providing false information may have consequences.

JUST  WALK-IN | MEDICAL CLINIC

Email

info@justwalkinclinic.ca

Business Hours

Open 7-Days a week, 10:00 am to 6:00 pm

Phone Number

+16478476262

Fax Number

+16477480830

Address

501 Pharmacy Ave Unit 1, Scarborough, Ontario, Canada
M1L 3G7
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Just Walk-In Clinic