Medical certificates, commonly referred to as ‘sick notes,’ play an important role in confirming when a person is medically unfit to attend work or perform certain duties. In South Africa, the issuance of medical certificates by registered practitioners is regulated in terms of the ethical and professional rules of conduct for practitioners registered with the Health Professions Council of South Africa (Rules).
These rules ensure that medical certificates are issued responsibly, ethically, and based on sound professional medical judgement.
Practitioner’s stakeholders, especially employers, rely on these certificates to verify legitimate, authenticity and of leave of absence reimbursement due to illness, ailment or malady.
Because of their legal and professional significance, medical certificates shall meet strict ethical and professional requirements as stipulated in the rules.
Minimum Requirements for a valid medical certificate
According to rule 16, a valid medical certificate must include the following information:
- Practitioner details: Name, address, and professional qualifications of the practitioner.
- Patient details: Name of the patient.
- Employment number (where applicable).
- Consultation details: The date and time the patient was examined.
- Basis of the certificate: Whether the certificate is based on personal observations from a medical examination, or on information provided by the patient based on acceptable medical grounds.
- Description of the illness: A description of the illness, disorder, or condition in layperson’s terms, with the patient’s informed consent. If the patient does not consent to disclosure, the practitioner should simply state that the patient is unfit for work.
- Work capability: Whether the patient is totally unfit for duty or able to perform less strenuous duties.
- Recommended period of sick leave: The exact duration for which the patient should be absent from work.
- Certificate issue date: The date the certificate is issued.
- Practitioner identification: The practitioner’s initials and surname in block letters.
- The practitioner’s HPCSA registration number.
Guidance for practitioners
Registered practitioners shall ensure that medical certificates are issued only after appropriate clinical examination or after and that they comply with all ethical requirements.
Practitioners should remember that:
- A medical certificate must reflect professional medical judgment.
- Certificates should not be issued without proper consultation or examination, unless justified on acceptable medical grounds.
- Incomplete or vague certificates may be rejected by employers, of course with justification for such refusal.
- Issuing false or misleading certificates constitutes unprofessional conduct.
A practitioner who issues a medical certificate that does not comply with the rules may be reported to the HPCSA for investigation.
Guidance for the Public
Members of the public should also be aware that:
- A legitimate sick note must come from a registered health practitioner.
- The certificate shall include the practitioner’s HPCSA registration number.
- Patients have the right to confidentiality regarding their medical condition and can choose whether the illness is disclosed on the certificate.
- Medical certificates shall reflect a genuine medical assessment, not simply a request from a patient.
The public is encouraged to verify the registration status of practitioners and report concerns about fraudulent or unethical practices to the HPCSA.
Upholding ethical practice
Medical certificates are important documents that require integrity, professionalism, and adherence to ethical and professional standards. By ensuring compliance with the rules, practitioners help maintain trust in the healthcare system and protect both patients and employers.
The Council remains committed to safeguarding the public interest and promoting ethical and professional conduct by practitioners.
Last Updated on 9 March 2026 by HPCSA Corporate Affairs