Leave Applications

Leave Application for Medical Checkup Samples, Format, and Template

Medical Examination Leave Application Samples

In this unpredictable world, anyone can come across any unfavorable situation at any time of the day. Under such circumstances, what matters is how we react to such incidents. Since the matter itself cannot be controlled in certain cases, our reaction to it is one thing that we can adjust to make, if not the event favorable, then a little less unfavorable.

There can be loads of unwanted scenarios that we come across every single day. They may be different in nature, but they all may make us uncomfortable. Such events may include deaths, accidents, mild injuries, or serious diagnoses. All these are a part and parcel of life and the world doesn’t stop after any of these events, and neither should we! Even though the sorrow is real and is unneglectable, we should not let it stop us from doing things that are bound to. Then how to react under such circumstances is the real question here. By managing everything else and not letting one unfavorable condition get the best of you. 

If you are a student or an employee and face a hostile situation, it is best advised that you take some out to get out of the situation, without letting it have an adverse effect on your studies or job. Taking a leave in such a case is the best solution.

What is a Medical Docket?

A medical docket is a physical, mental, or clinical examination of a person in which a medical practitioner examines the patient for any sign or symptom of a medical condition. It is most commonly termed as a medical examination.

A letter of request in which a student or an employee asks for leave on account of a medical checkup is termed as an application for a medical checkup.

Such an application is addressed to the higher officials of a school (principal or teacher) or of an office (manager or HOD).

When is leave for medical checkup required?

Leave on the basis of a medical examination is not necessary to be asked when the person himself is the one to get checked. It can also be requested if any immediate relative of the student or employee has to get his checkup done and/ or get admitted. A person can ask for a leave on the basis of a medical checkup in the following conditions:

    • To address the serious health condition of an employee or a student
    • To address serious health conditions of the employee or student’s immediate relative (eg. Parents, siblings, children, grandparents, etc.)
    • In association with the death of an immediate relative.

These were the commonest causes of taking a medical leave. There can be several other cases under which a person may require an off from his school or office. But what’s important is that the exact reason is to be mentioned in the application for the doctor’s appointment.

How to write an application for a medical checkup?

An application for a medical checkup is, since, addressed to the higher authorities, it has to be crafted with great caution since it goes into the record of the institute. In this article, we have drafted for you the format for writing an application requesting leave due to a medical checkup along with a sample for your better understanding. Also, stay tuned to get some amazing tips at the end.

Format of Leave Application for Medical Examination:-

An application for a medical checkup, unlike regular applications, usually has to be turned in by hand. This means that the leave, usually, is not accepted on an online portal. Here is a standard format of an application for a medical examination so that you can save the time it takes to search for one.

  • Date:-

The letter starts with the date on which it is written on the top left corner of the page.

  • Recipient’s address:- 

The recipient’s particulars are next in line in the application. The basic details in the designation of the recipient body, the name of the institute (either school or company), and the name of the city is mentioned herein.

  • Subject line:-

Leaving a line after the recipient’s address comes the subject line. This line acts as the header for the application. It precisely describes the main theme of the application so that it could be perceived at a quick glance.

  • Salutation:-

Then come the greeting words which double as an opening of the application. It consists of the phrase ‘Respected Sir/ Madam’ or ‘Honorable Sir/ Madam.’

  • Main body:-

The main body is divided into a maximum of three paragraphs which contain the detailed reason for taking a leave.

  • Words of gratitude:-

The application should be able to depict courtesy on the part of the sender. It is, therefore, recommended to end the body with a thank you note.

  • Enclosure:-

In case the institute demands proof of the reason for leave, that is, a medical certificate or any such document, the name of the document is to be mentioned over here.

  • Contact info:-

Contact details are not necessary for students who write the applications. Employees, however, have to include their contact details in the actual letter.

  • Sender’s address:-

The sender’s address is the last component of the application. It contains the basic details of the sender such as his name, class, signature, etc.

Medical Checkup Leave Application Sample

An application for leave of a student on the basis of a medical checkup can either be penned out by himself or by either of his parents. This sample has been constructed from the view of a mother asking for her ward’s leave due to a medical emergency.

Date: July 15, 2023

The Principal,
(Name of school),
(Name of city).

Name of Application Sender,
Details of the applicant.

Subject: Request for leave due to medical emergency.

Respected Sir/ Madam,

This is to inform you that my son/ daughter, (name of student) is a student of Class XYZ in your school. It is stated that my mother is having an appendix operation in the coming Tuesday. For this reason, my son/ daughter will be unable to attend school for three days, that is, from the 19th to the 21st of July.

Therefore, it is requested to kindly grant him/ her three days’ leave from school.

Thanking you in anticipation.

Yours Obediently,
(signature of applicant),
Guardian Name,
(Class of student).

Tips for Writing an Application for Medical Examination:-

Here are our top tips on how to make the most out of your application for medical examination:-

  • Mention the exact dates:-

It is best advised to mention the exact number of days, with the dates, for which the leave is required.

  • Be honest:-

The exact reason should be mentioned as to why the leave is being requested. Honesty should be given primary importance in the letter.

  • Revise and recheck:-

Revising and rechecking the application before turning it in is a good activity as it minimizes the risk of unnecessary errors.

Final Wordings:-

This article was published with a view to clear your mind of all doubts related to applications requesting leave due to a medical emergency. If you still have some doubts, feel free to use the online template as your own by making modifications as per your requirements.

With that said, this article has reached its end. Make sure to leave your valuable feedback in the comments section below. Cut!

Yousaf Saeed

I'm Dr. Engr. Yousaf Saeed, founder of the AScholarship Education Portal. My academic path includes 3 prestigious international scholarships — Australia Awards, CSC, and HKPFS — for my higher studies. I am also an IChemE affiliate whereas I've also worked for companies like Aramco and BYCO oil refinery as an production engineer at the start of my career. I completed MS, and PhD with major research publications in leading SCI journals (details on my Researchgate Profile). This aScholarship.com reflects my commitment to educating and therefore i started it for the purpose to guide aspiring international students for find scholarships for their higher education dream. As an experienced educator and mentor, I specialize in navigating the intricacies of research and patent and write useful articles on these topics too.

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