What a Real Doctor's Note Looks Like — and How to Spot a Fake

Adam Z. Kawalek, MD

June 11, 2026 · 2 min read

People ask me all the time what a "real" doctor's note is supposed to look like — usually because an employer pushed back on one, or because they want to make sure the one they're getting will actually be accepted. As a physician, here's exactly what belongs on a legitimate note, what's deliberately left off, and the red flags that give away a fake.

What a legitimate doctor's note contains

A real medical note doesn't need to be fancy, but it does need to be verifiable. At a minimum, a legitimate note includes:

• The name and credentials of the clinician who issued it (for example, a physician's name followed by MD or DO)
• The provider's NPI number — a unique National Provider Identifier that can be looked up in a public federal registry
• State license information for the issuing clinician
• The date the note was issued
• The specific dates you're being excused from work or school
• An actual signature — handwritten or a verified electronic signature
• A way to contact or verify the issuing office
• Often a clinic or service name and address

What a real note deliberately leaves OFF

Here's what surprises people: a good doctor's note usually does not list your diagnosis. It confirms that you were under a clinician's care and the dates you should be excused — and stops there. Your employer is entitled to confirmation that your absence is medically supported, not to your private medical details. A note that overshares symptoms or diagnoses isn't more legitimate — it's just less private.

How employers actually verify a note

Most employers don't care which clinic a note came from. They care that it's real, and they have a few ways to check. They can look up the NPI number in the public registry to confirm the provider exists and is who the note says they are. They can call the verification number on the note. And increasingly, notes carry a QR code that links to a verification page confirming the document is authentic. A SickSlip note includes the physician's NPI, state license, a verification line, and a QR code, so an HR team can confirm it in seconds.

Red flags of a fake note

Fake and template notes are common, and HR departments have gotten good at spotting them. The giveaways:

• No identifiable clinician — just a generic "doctor" or a clinic name with no real provider behind it
• No NPI number, or an NPI that doesn't match the name when you look it up
• No way to verify it — no working phone number, no verification page
• Obvious template artifacts, misaligned logos, or spelling and formatting errors
• A note that lists a dramatic diagnosis it has no business disclosing
• A 'note' generated instantly by a template tool with no clinician review at all

Why a verifiable note protects you

The whole point of documentation is that someone can check it and it holds up. A note tied to a real, licensed physician with a public NPI and a verification path isn't just more likely to be accepted — it protects you if anyone ever questions it. A note that can't be verified does the opposite: the moment HR can't confirm it, it works against you.

The bottom line

A real doctor's note is simple but verifiable: a named, licensed clinician, an NPI, the dates you're excused, a signature, and a way to confirm it's authentic — with your private diagnosis kept out of it. If a note is missing those, no formatting tricks will make an employer trust it. If it has them, where you were physically seen stops mattering.

Adam Z. Kawalek, MD

Board-Certified Physician · Founder, SickSlip · Cedars-Sinai · Johns Hopkins

Dr. Kawalek is a hospitalist physician with 15+ years of clinical experience. He founded SickSlip to give patients fast, affordable access to legitimate medical documentation without unnecessary clinical barriers.