59MDWI44-174 governs completion and submission of the 59th Medical Wing Form 903, Excuse Slip.
View 59MDWI44-174 on armypubs.army.mil
It covers the form’s use for school age children absent from school for a dental or medical reason, including return timing, gym limitations, medicines at school, and other relevant information. It requires healthcare providers to ensure the form is accurate and complete, sign it, and submit it to the student’s school office.
Applies to: This instruction applies to all personnel assigned, attached or under contract to the 59th Medical Wing.
The purpose of 59 MDW Form 903, Excuse Slip is to document a dental or medical reason for a school age child missing a specified period of time from school. (paragraph 1)
The form also indicates when the student may return to school, if there are any limitations with gym activities, if medicines need to be administered at school, and any other relevant information. (paragraph 1)
All 59 MDW staff who work in areas that care for school age children will use the 59 MDW Form 903. (paragraph 2)
The healthcare provider must sign the form.
The 59 MDW Form 903 is submitted to the student’s school office. (paragraph 3)