Medical Clearance Letter Template [10+ Templates To Download]

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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 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 letters template in these scenarios are sought after. Hence, their ability to convey in detail what the person can or cannot do is important.

174+ Medical Templates in PDF, Word, Excel, PSD, Google Docs, InDesign, Apple Pages, Google Sheets, Publisher, Apple Numbers, Illustrator - START DOWNLOADING

5 Steps to Write a Medical Clearance Letter

Step 1: Have a Purpose

Each medical clearance 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 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

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File Format
  • PDF

Size: 123 KB

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The template is to be used 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.

2. Medical Pre-Op Clearance Letter

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  • PDF

Size: 117 KB

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This template is usually filled out by a general physician. Ideally for orthopedic surgeons to use as a medical surgery clearance 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. It comes in PDF format.

3. Dental Clearance Letter Template

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  • PDF

Size: 38 KB

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The template is simple yet 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.

4. Medical Clearance Letter Template

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File Format
  • PDF

Size: 185 KB

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The 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 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

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  • PDF

Size: 81 KB

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This medical clearance 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.

6. Medical Clearance Letter for Physical Activity

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  • 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 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

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  • 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.

8. Basic Physical Ability Clearance Letter

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  • 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 formal 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

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  • PDF

Size: 7 KB

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Institutions with a fitness program will benefit most from this template. The free letter template 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

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  • 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

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File Format
  • PDF

Size: 56 KB

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This 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.

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