Doctor's certificate for B.C. government employees

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.

The current version of the doctor’s certificate form (ST02) is dated 2019/03/11. Older versions should not be used.

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 was used as an interim measure for telehealth appointments, during COVID-19 only. This form is no longer available.

When a doctor’s certificate is needed, B.C. government employees should use the two-part doctor’s certificate (ST02) form available from their supervisor.