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Table of Contents

  1. 5 Steps to Write a Medical Clearance Letter
  2. 10+ Medical Clearance Letter Templates
  3. 1. Medical Surgery Clearance Letter Template
  4. 2. Medical Pre-Op Clearance Letter
  5. 3. Dental Clearance Letter Template
  6. 4. Medical Clearance Letter Template
  7. 5. Medical Clearance Letter for Athletes
  8. 6. Medical Clearance Letter for Physical Activity
  9. 7. Medical Clearance Letter for Insurance Coverage
  10. 8. Basic Physical Ability Clearance Letter
  11. 9. Medical Clearance Letters for Fitness Programs
  12. 10. Medical Clearance Letter for Fitness Facilities
  13. 11. Medical Clearance Letter for Exercise Classes

Medical Clearance Letter Template [10+ Templates To Download]

A clearance letter in the medical field is issued to the recipient, granting them the authority to proceed with something. For example, insurance agencies or employers, need a clearance sample letter giving the person a clean chit of health. People who have had heart surgery would need a clearance form before starting vigorous physical activity. Or a patient would need a certain ‘go-ahead’ in the form of a clearance letter for a surgery. The reasons are myriad but medical clearance letter templates in these scenarios are sought after. Hence, their ability to convey in detail what the person can or cannot do is important. You can also see more on Medical Letter Templates here.

5 Steps to Write a Medical Clearance Letter

Step 1: Have a Purpose

Each medical clearance simple letter has a purpose. It may be to certify someone fit to study, work, exercise or have a medical procedure done. Tailor your letter keeping this specific purpose in mind.

Step 2: Spell It Out

The procedure of evaluation that was followed to give the patient a ‘Thumbs up or down’ needs to be spelt out. Make sure the right questions are answered. Mention very clearly whether the person was deemed fit or not at the end.

Step 3: Whom Is It For?

The consulting practitioner whether you are a dentist, ophthalmologist, general physician make sure the document carries your qualifications. A general physician surely cannot give a dental clearance basic letter. So having your qualifications and designation on a clearance letter you give out is highly important.

Step 4: Keep It a Secret

The patient might not be a regular but all bits of doctor-patient confidentiality apply too. Make sure the results are kept safe and not shared with a third party.

Step 5: Remember to Sign Off

Finally, remember to include your signature and medical seal. Leave enough contact information on your letterhead so that you can be contacted, in case further clarification is required.

10+ Medical Clearance Letter Templates

1. Medical Surgery Clearance Letter Template

medical surgery clearance letter templategatewaybariatrics.com
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File Format
  • PDF

Size: 123 KB

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The sample templates are intended for medical clearance before surgery. The letter template is free. It includes elements of color. Its most attractive quality is that the letter has an option of requesting for more information about the patient built into it. You can also see more on Medical Thank You Letters.

2. Medical Pre-Op Clearance Letter

medical pre op clearance letterazisks.com
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File Format
  • PDF

Size: 117 KB

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This simple template is usually filled out by a general physician. Ideally for orthopedic surgeons to use as a medical surgery clearance sample form for their patients. The design focuses on whether the patient is fit for surgery or not. The letter format template is free of cost. This letters in pdf format also  available.

3. Dental Clearance Letter Template

dental clearance letter templateswedish.org
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File Format
  • PDF

Size: 38 KB

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The basic template has an element of color to it. The top of the template gives space for having the hospital’s logo fixed. This formal letter format template is best suited as clearance letters for heart and thoracic surgeons to get a patient’s dental status before surgery. It gives instructions as to what should be done with the form after it is filled as well. You may also find medical agreement templates.

4. Medical Clearance Letter Template

medical clearance letter templateaugusta.edu
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  • PDF

Size: 185 KB

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The printable template comes in PDF format. If you are looking for a versatile clearance letter template then that is exactly what this template is. The letter format template does not specify a recipient. It can be used for medical clearances for workplaces as well. Here only a dental clearance is mentioned now, customize and edit as per your requirement.

5. Medical Clearance Letter for Athletes

medical clearance letter for athletesparachutecanada.org
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File Format
  • PDF

Size: 81 KB

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This clearance of medical letter template is ideally suited for athletes returning to the sport. It is in PDF format. The letter template is two pages long. The second page entails instructions that the athlete could follow during the interim period between his setback and his return. You can also see more on Medical School Letters.

6. Medical Clearance Letter for Physical Activity

medical clearance letter for physical activityalabamapublichealth.gov
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File Format
  • PDF

Size: 377 KB

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It is normal that each person being unique will have different health conditions. Certain conditions can restrict certain activities. Medical clearance simple forms help to know your limits. You can customize this simple letter template in for specific medical conditions. It is ideally suited for medical conditions that could restrict physical activity or exercise for a person.

7. Medical Clearance Letter for Insurance Coverage

medical clearance letter for insurance coveragebedford.k12.mi.us
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File Format
  • PDF

Size: 14 KB

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This is a free medical clearance letter template. It can be for used by insurance companies to know what benefits a person can claim. It is perfect for a person who must receive a Medical Clearance letter from a physician for claiming hearing aid services. Instructions outlining the process of evaluation before giving clearance is a plus point this sample letter writing template carries. You can also see more on Medical Illustration Templates.

8. Basic Physical Ability Clearance Letter

basic physical ability clearance lettersaskatoonpolice.ca
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File Format
  • PDF

Size: 178 KB

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Many services require employees with certain physical abilities and caliber. They form the main basis on which the employer considers their appointment for the simple reason that the job requires them to put these abilities to the test on a daily basis. The design letter template clearly explains the demands of the post to the physician conducting the tests to ensure accurate results.

9. Medical Clearance Letters for Fitness Programs

medical clearance letters for fitness programsbrandeisjudges.com
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File Format
  • PDF

Size: 7 KB

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Institutions with a fitness program will benefit most from this template. The free letter templates breaks down the clearance letter into three parts. It lets the physician know why the person needs the letter. It includes a section where it takes consent from the person undergoing the evaluation as well as a section for the physician’s recommendations, making it highly useful.

10. Medical Clearance Letter for Fitness Facilities

medical clearance letter for fitness facilitiesexerciseismedicine.org
Details
File Format
  • PDF

Size: 54 KB

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The template can be used by fitness facilities who want to make sure that their clients are fit to participate in their programs. The one-page template is simple and effective. The letter template also carries some color and the header can be customized as per requirement.

11. Medical Clearance Letter for Exercise Classes

medical clearance letter template for exercise classesnslhd.health.nsw.gov.au
Details
File Format
  • PDF

Size: 56 KB

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This general template is well organized. It specifies the different elements of the exercise classes. Hence, the formal letter template is very comprehensive and in-depth as it would ensure that the physician gets a clear picture of what he needs to ‘okay’ the patient for.

Explore additional medical clearance letter templates on our website, template.net, to find a variety of options that suit your needs.

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