Doctor's certificate for B.C. government employees

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Supervisors, please ensure you have an adequate supply of Doctor’s Certificate forms (ST02) on hand. If you or your employees work remotely or in a hybrid model, please provide each employee with a form to keep at home for future use.  Supervisors and managers can order the form by logging into their office’s account with the Distribution Centre Victoria (DCV).

Once you’re logged in:

• Search under 'Forms'
• Select or search for 'Short Term Illness and Injury Plan Doctor’s Certificate - Product #7530951064

Telehealth doctor’s certificate form

The telehealth doctor's certificate form can be used for telephone and/or virtual medical appointments during COVID-19 as outlined above.

This form is for B.C. government employee use only.

This form is to be completed by the employee (Part A and B) and physician or nurse practitioner (Part C and Physician’s Confidential Report), then forwarded to Occupational Health and Rehabilitation. OHR staff will review all telehealth doctor’s certificate forms and a clinician will update the supervisor if required. 

Employee: Please forward both the completed telehealth doctor’s certificate form and instruction to your physician or nurse practitioner. Once completed by your physician or nurse practitioner you should obtain a copy of the form and provide a copy without the Physician’s Confidential Report Section to your supervisor. You are not required to provide your confidential diagnostic information to your supervisor.

• Telehealth doctor’s certificate form and instructions (PDF, 1.2MB)
• How to add an electronic signature (PDF, 228KB)

Doctor's certificate form (ST02)

The doctor’s certificate form (ST02) is a two-part form designed to provide:

• A supervisor with guidance about an employee’s limitations, restrictions, and return to work prognosis (short portion of the form)
• Confidential diagnostic information directly, and only, to Occupational Health and Rehabilitation (long portion of the form)

This form is for B.C. government employee use only.

The short portion is provided to supervisors who are responsible for identifying modified duties within their work units that meet an employee’s restrictions and limitations. It also provides supervisors with the return to work prognosis. Supervisors need to keep the short portion of the form in the work unit as a record.

Employees are instructed to forward the long portion, which contains confidential diagnostic information, directly to Occupational Health and Rehabilitation.

A quick reference guide at the very front of the form outlines responsibilities and explains how to use the form. Employees can obtain the form from their supervisor.

Employees will be reimbursed by their work unit or ministry for 50 percent of the cost of completing the form.

Supervisors and managers can order the form by logging into their office’s account with the Distribution Centre Victoria (DCV).

Once you’re logged in:

• Search under 'Forms'
• Select or search for 'Short Term Illness and Injury Plan Doctor’s Certificate - Product #7530951064'