Lto medical certificate form 2026

1. Click ‘Get Form’ to open the lto medical certificate form in the editor.
2. In the first section, enter your student number and provide your name. This authorizes the physician to share necessary information with the University of Western Ontario.
3. Sign and date the authorization section to confirm your consent for the physician to complete the form.
4. Next, the physician will fill out their section. They should certify that they provided health care services, including dates and details about your condition.
5. The physician must indicate whether your issue is acute or chronic and specify any reasons why you could not fulfill academic responsibilities.
6. Finally, ensure that the physician completes their verification by providing their name, signature, registration number, address, and contact information.

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