Cases that do not require medical documentation:
- Psychological/Psychiatric conditions
All other cases:
Physicians must complete a medical documentation form. It should:
- include detailed information
- be stamped by the physician’s office or include a letter on the physician’s letterhead
- be submitted to the Leave Bank Office via:
- Email: LeaveBank@od.nih.gov or
- Fax: 301-480-2579
All medical documentation will be kept confidential.
If medical provider and patient are located outside of the USA: submit medical documentation regardless of the type of medical emergency.
Please visit our Leave Bank Recipient Homepage for more information.
For questions, email LeaveBank@od.nih.gov or call (301) 443-8393.