The Evolution of Medical Certificates in Australia: From Paper Notes to Telehealth

Medical certificates in Australia have moved from handwritten notes on a doctor’s letterhead to digital documents that can be issued after a phone or video consultation and forwarded to an employer in minutes. Along the way, the rules about who can issue them, when employers can ask for them and how telehealth fits in have all changed.

Here’s a short history of how we got here, and what it means for you today.

The paper era: the doctor’s note

For most of the 20th century, a “doctor’s certificate” meant a visit to your local GP, a quick examination and a handwritten note. There was no standard format. What counted as acceptable evidence of illness, and when you had to provide it, depended on your award, your employer or your state’s laws.

This worked well enough when most people had a regular family doctor nearby. It was harder for shift workers, people in rural areas, parents of sick children and anyone too unwell to sit in a waiting room.

2010: national rules for sick and carer’s leave

A major change came with the Fair Work Act 2009. From 1 January 2010, the National Employment Standards (NES) set minimum leave entitlements for employees covered by the national workplace relations system, including:

• 10 days of paid personal (sick and carer’s) leave a year for full-time employees, with part-time employees receiving a pro rata amount
• 2 days of unpaid carer’s leave for each occasion it’s needed, including for casual employees

Section 107 of the Act also set a common standard for evidence. Employees must tell their employer as soon as practicable that they’re taking leave, and if asked, give evidence that would satisfy a reasonable person. A medical certificate is the most common form of evidence, but a statutory declaration can also be used. Awards and enterprise agreements can set out more detail.

We explain these rules in practical terms in When do you need a medical certificate in Australia?

Pharmacists join in

Professional pharmacy bodies have published guidelines that allow pharmacists to issue a “certificate for absence from work” for minor, short-term illnesses they can assess in the pharmacy, such as a cold or a mild stomach upset. These certificates gave people another option for a day or two off work, especially when a GP appointment wasn’t available.

Pharmacist certificates have limits. They’re intended for short absences and may not be accepted for every purpose, such as university special consideration or insurance claims. For anything longer or more complex, a doctor’s assessment is usually needed.

2020: telehealth becomes mainstream

Before 2020, telehealth in Australia was mostly limited to specialist consultations for people in rural and remote areas. That changed quickly during the COVID-19 pandemic, when Medicare introduced temporary telehealth items so people could see a GP by phone or video without leaving home. Electronic prescriptions (eScripts) were also introduced around the same time.

Telehealth was made a permanent part of Medicare from 1 January 2022. For many people, a phone or video consultation became a normal way to get a medical certificate, as well as prescriptions and referrals.

Medicare rebates for GP telehealth are now generally linked to an existing relationship with a practice. Our article Telehealth and Medicare: the 12-month rule and MyMedicare explained covers how this works.

2023: clearer standards for online certificates

As online health services grew, some websites began issuing certificates based on an online form, with no conversation with a doctor. In response, the Medical Board of Australia revised its telehealth guidelines. From 1 September 2023, the Board stated that prescribing, issuing certificates and referring through questionnaire-only tools, without a real-time consultation, is not good practice.

This means a valid online certificate today should come from a genuine phone or video consultation with a registered doctor who takes a history and makes a clinical judgement, just as they would in person.

What hasn’t changed

Despite the move to digital, the basic principles of a medical certificate are the same as they were in the paper era:

• it must be issued by a registered health practitioner after assessing you
• it should only certify what the practitioner knows or reasonably believes to be true
• it’s dated on the day you’re seen, not backdated
• your diagnosis stays private unless you agree to share it

For a detailed checklist of what a certificate should include, read Medical certificates in Australia: requirements and basics.

Medical certificates today

Today, you can choose how you get a certificate: from your regular GP in person, from a pharmacist for a short minor illness, or from a telehealth GP by phone or video. Each has its place. In-person care is still important when you need an examination, a workers’ compensation certificate or a fitness-for-work assessment.

If you’re unwell and don’t need a physical examination, telehealth can save you a trip when you’re least up to it. Our guide to getting a medical certificate online walks you through the process.

How Teldoc can help

Teldoc’s AHPRA-registered GPs consult by phone or video, 7 days a week from 9 am to 7 pm (Sydney time), and most patients are seen within 15 minutes. If the doctor assesses that you’re unfit for work or study, or need to care for someone who is unwell, they can issue an online medical certificate that’s sent to you electronically.

General consultations are $55 on weekdays and $75 on weekends and public holidays, with no Medicare rebate. See our fees page for details. Telehealth isn’t for emergencies. If you’re seriously unwell, call 000.

Frequently asked questions

When did telehealth medical certificates become common in Australia?

Telehealth GP consultations became widely used from 2020, when Medicare introduced telehealth items during the COVID-19 pandemic. Telehealth was made a permanent part of Medicare from 1 January 2022.

What did the Fair Work Act change about medical certificates?

From 1 January 2010, the National Employment Standards set minimum sick and carer’s leave entitlements and allowed employers to ask for evidence that would satisfy a reasonable person, such as a medical certificate or statutory declaration.

Can pharmacists issue medical certificates?

Pharmacists can issue a certificate for absence from work for short, minor illnesses they can assess. These are generally for a day or two and may not be accepted for every purpose.

Are certificates from online questionnaires valid?

The Medical Board of Australia says issuing certificates through questionnaire-only tools, without a real-time consultation with a doctor, is not good practice. Look for a service that offers a genuine phone or video consultation.

This article is general health information and isn’t a substitute for advice from your own doctor. If you’re worried about your health, speak to a GP. In an emergency, call 000.

Medically reviewed by Dr Vafa Derakshan (MBBS, FRACGP), September 2026