Doctor's Certificate for B.C. Government Employees

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).

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. Until April 1, 2020, employees pay for the completion of the form. After this date, 50% of the cost of the form will be reimbursed by your work unit or ministry.

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

Once you’re logged in:

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