Forms for Absences from Work, including FMLA

Carolina Conceptions, as your medical provider, can provide excuse notes for the following items ONLY:

  • Work Excuses for monitoring visits, procedures (other than retrievals) – only apply for the immediate date/time frame of the visit. Most do not consume more than an hour of time.
  • Work Excuses for outpatient surgeries involving laparoscopy – excuse notes will be for 5 days duration from the date of surgery.
  • Work excuses for retrievals – excuse notes will be for one day in duration from the date of retrieval.
  • If FMLA is used for a day or a few days as listed above, the patient can complete the remainder of the FMLA form and use the note as an attachment.

Notes can be requested when in the office for visits or via the portal.

Notes can be attached to and used for FMLA submissions and will meet the legal certification criteria for the date or days, as listed above. Additional time away from work is not considered within the scope of our outpatient medical services.