Medical Documentation

Cases that do not require medical documentation:

• Appeals
• 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.