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Medical Note

This medical note confirms that Kaushikkumar Mangukiya has been under treatment for musculoskeletal back pain and requires medical leave from May 4, 2026, to May 25, 2026. He is cleared to return to work on May 26, 2026, with specific restrictions to avoid heavy lifting, prolonged sitting or standing, and strenuous activities for at least four weeks. The employer is requested to accommodate these limitations to support the patient's recovery.

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2 views1 page

Medical Note

This medical note confirms that Kaushikkumar Mangukiya has been under treatment for musculoskeletal back pain and requires medical leave from May 4, 2026, to May 25, 2026. He is cleared to return to work on May 26, 2026, with specific restrictions to avoid heavy lifting, prolonged sitting or standing, and strenuous activities for at least four weeks. The employer is requested to accommodate these limitations to support the patient's recovery.

Uploaded by

batakalari795
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We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd

co✓ HEAi, LIFE WELLNESS

DR. \VILLI \l\1 Cll \N Ml)

Ma~ 2.5, 2020

Attt'ntion: Linda,
Re: l\1cdical Nole for Kaushikkumar Mangukiya
l)ea1 Linda,

Tlns letter is to confirm that Kaushikkumar Mangukiya has been under my medical care at Heal Life
\\ellness for the treatment of musculoskeletal back pain. The patient has been receiving regular
treatment including therapeutic massage, spinal adjustment, and related rehabilitative therapies.
The patient was advised to take medical leave from May 4, 2026 through May 25, 2026 to allow for
--
adequate rest and recovery. During this period, the patient attendea the clinic regularly for ongoing
treatment. The patient did attend work on a limited basis on certain days when symptoms were
manageable, but was otherwise unable to perform full duties due to the condition.
Mr. Mangukiya has been cleared to return to work effective May 26, 2026, subject to the following work
restrictions:
• No heavy lifting (nothing exceeding 20 lbs )
• Avoid prolonged sitting or standing for more than 1.30 minutes at a time
• No repetitive bending, twisting, or strenuous physical activity
• Periodic breaks to stretch and change posture are recommended

These restrictions are recommended for a minimum of four (4) weeks following the return to work
date, after which the patient will be reassessed. I kindly request that the employer accommodate these
temporary limitations to support the patient's full recovery.
Sincerely,

~~
Dr. William Chan, MD
Heal Life Wellness
4125 Lawrence Ave East, Unit 101

I [Link] info(a hcallifc,vellness.con1


4123La\\r<'11<.< \,pl\t~t Lnil 101 S<<[Link].:\ltE:lS2

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