How to Get a Doctor's Note to Excuse a School Absence

What a school excuse note actually needs to include

Schools generally need something simple:

• The child's name
• The date(s) of absence
• A statement that the child was seen by a licensed clinician and medically excused
• The clinician's name, credentials, and contact information or signature

Most schools do not require — and should not request — a specific diagnosis. A diagnosis is protected health information, and under the HIPAA Privacy Rule your healthcare provider cannot share it with a school without your written authorization 1Ref 1U.S. Department of Health and Human Services, Office for Civil Rights (2023).Employers and Health Information in the Workplace.Healthcare providers cannot share a patient's health information (including a diagnosis) with a school or employer without written authorization; a note confirming a visit is distinct from disclosing the underlying medical condition. A general note stating "was seen and is excused from school on [date(s)]" is almost always sufficient.

If your school is asking for a specific diagnosis, ask the school administrator what policy authorizes that request. In most cases they do not actually need it.

Who can write a school excuse note?

Any licensed clinician who evaluated your child can write the note, including:

• A primary care pediatrician or family medicine physician
• A physician assistant (PA)
• A nurse practitioner (NP)
• A licensed clinician at an urgent care or retail clinic
• A telehealth provider following a virtual video visit

If the school requests specifically an MD or DO, confirm that with the clinician's office in advance.

How to request the note

Call or message the pediatrician's office and let them know you need a school excuse note following the visit. If the visit already happened, most offices can add the note to the visit summary or send it electronically — ask whether they will fax it to the school or provide a PDF you can forward.

If your child has not yet been seen for this illness and the absence is ongoing, schedule an appointment first. Clinicians generally will not write a note for an illness they have not evaluated.

For telehealth visits, the note is typically provided as a document in the patient portal or sent by email after the visit.

Is a telehealth visit a valid way to get the note?

Yes, for most schools. A telehealth visit conducted by live video is a legitimate clinical encounter 2Ref 2U.S. Department of Labor, Wage and Hour Division (2021).DOL Permanently Allows Telemedicine to Count as In-Person Visit for FMLA Purposes.Since December 2020, the U.S. Department of Labor has permanently recognized telehealth video visits as qualifying 'in-person' clinical encounters for FMLA certification — the same standard supports telehealth-based school excuse notes. It is often the fastest option when your child is home sick and you need documentation quickly. Many telehealth platforms offer same-day appointments with licensed clinicians who can evaluate your child's symptoms and provide a school excuse note as part of the visit summary.

Telehealth notes carry the same standing as in-person notes as long as a licensed clinician evaluated the patient via video. However, confirm with your school's office before scheduling — some districts specify they require an in-person exam, particularly for extended absences of five or more days or for certain conditions.

What about chronic conditions and frequent absences?

Children with conditions like asthma, anxiety, migraines, or a chronic pain condition may miss school repeatedly. In these situations, a standing letter from the treating specialist — describing the condition and its effect on attendance — can reduce the burden of requesting individual notes for each absence.

Some schools also have formal accommodation plans (such as a 504 Plan) that address attendance and medical needs systematically. Your child's clinician can document the condition in support of such a plan if the school suggests it.