This form is intended for employers, schools, insurance providers, government agencies, and other organizations that wish to verify the authenticity of a medical certificate issued by Dr. Quesada. Information submitted through this form will be used solely for certificate verification. By submitting this form, you confirm that you are authorized to request verification on behalf of your organization.
A Verification Certificate will be emailed to the requesting organization confirming:
that the medical certificate was issued by Dr. Mary Natalie C. Quesada.
the date it was issued
the Certificate ID and Verification Code (which should match those on the original medical certificate)
the recommended recovery period, if applicable
the recommended date to return to work or school, if applicable
Diagnosis, treatment details, consultation notes, or other confidential medical information will NOT be disclosed.
Verification requests are processed during office hours only. Verification will be emailed within 24-48 hours.
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