Letter to a Worker's Doctor by Acas
This template is a formal letter for an employer or organization representative to send to a worker's doctor. It requests specific medical information about the worker, such as absence dates, health conditions, and their impact on job responsibilities, to assist with sick pay management, work planning, or worker support. The letter includes placeholders for details like the worker's permission and specific information needed.
Letter to a Worker's Doctor
To: [doctor’s name]
[Doctor’s address]
From: [your name]
[Name of your organisation]
[Address of your organisation]
[Today’s date]
Dear [doctor’s name]
I am writing for information about your patient [name of worker], who lives at [address of worker].
I am [a / an] [your role] at [name of your organisation]. Your patient works as [a / an] [worker’s job title] at the organisation.
I have attached the worker’s permission for me to make this request. They [want / do not want] to see the report before you send it to me.
I would like information in order to manage [sick pay / plan work / support the worker].
I would like information about:
[List the things you’re asking about. For example:
their absence from work, including absence dates
their health condition, such as a broken wrist]
Their role involves:
[List any worker tasks or responsibilities the condition might affect. For example:
standing for long periods
heavy lifting
working evenings
using a keyboard
driving]
I would like to know:
[List any other information you need. For example:
the condition's impact on carrying out their tasks or responsibilities
whether the worker is disabled
reasonable adjustments that might be needed
a likely date the worker will return to work
if a phased return to work, change of duties or other support might help the worker]
Let me know if I need to pay a fee for this information.
If you’re unable to provide the requested information quickly, please reply to confirm you’ve received this.
Please reply [by email / by post - a stamped addressed envelope is enclosed].
Yours sincerely,
[Your name]
[Your telephone number]
[Your email address]
5.0 out of 5 on Google
Read reviewsAs seen in
Frequently asked questions
A template isn't binding on its own - like any contract, it becomes binding once it's properly completed and signed. Templates in our curated library are professionally drafted for US or UK law; review any template before you sign it.
Yes. Chat with GitLaw to edit any section, or make changes directly in the editor.
Yes, read about team plans here.
Describe what you need in the chat and GitLaw will draft it for you.
Templates in our curated library are professionally drafted for US or UK law. The wider library comes from the GitLaw community and public sources - a solid starting point, but check any template fits your situation before you rely on it.
Mostly US and UK law. Some templates use general commercial terms that work across jurisdictions, and many note which law they're written for.
It depends on the situation. Templates work well for routine business agreements. For anything involving significant money, complex IP, employment, or areas you're unsure about, it's worth getting professional advice before you sign. GitLaw provides templates and tools, not legal advice.
Open any template in GitLaw and describe the change you want in the chat — 'make clause 4 mutual' or 'add a 30-day notice period', for example. GitLaw drafts the revised language and shows it as a suggested edit. You accept, reject, or keep editing from there.
Yes. Upload a Word, PDF, or Markdown file and GitLaw will open it in the editor. You can review, edit, or chat with GitLaw about it the same way you would with any template from the library.
Trusted by thousands of businesses
From template to signed, in one place
Every template opens in an editor with an AI agent alongside it.
Open
Pick a template and open it. Nothing to download, and no credit card to start.
Free to open
Edit with AI
Describe your situation in chat and the agent adapts the wording, clause by clause.
Tracked changes you can review
Send and sign
Share it for negotiation, then collect signatures without leaving GitLaw.
eSign included
Built for your legal work, with practicing lawyers
Trained on 5.5K+ clauses and specialist areas of law. Built with a standards committee of independent lawyers.
As seen in
Start free
No sales calls, no credit card. Just chat with GitLaw.
GitLaw provides templates and tools, not legal advice. Templates are a starting point, not a substitute for advice on your situation - for anything significant, speak to a qualified lawyer.