One-liner#

Clear, minimal notes reduce back-and-forth and protect clinician time.

Documentation checklist#

• Medical issue (broad, privacy-preserving when possible) and date(s) affected
• Functional limitation (what they can/can’t do) and expected duration
• Return-to-work/school date and restrictions (if any)

Boundaries#

• Avoid diagnosing beyond what you assessed
• Avoid certifying disability/limitations without an exam or objective basis