Medical License Form: Medical License Request

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Medical license formIf, as a worker in the education sector, you face a situation that requires you to process a service license to take care of yourself for your own medical reasons or that of a close relative.

If you need to obtain a quick and practical guide on how to process your Medical License Form, we invite you to read the following article.

Medical License Form LM-01

The LM-01 medical license form is an instrument that, in compliance with the agreement signed by the Faculty of Medical Sciences of the National University of Rosario, and the Ministry of Education, facilitates and systematizes the requests for medical leave made by the workers of the education sector.

The form is freely provided by the Santa Fe government portal, anyone interested in processing a license must download and fill it out in order to start their corresponding procedures.

Form LM-01

How to complete the form

Follow the following guide to fill out the form described item by item, you must be clear that the first thing to do is download the aforementioned form, review the link: Form LM-01.

  1. All workers must inform that they will be absent from the establishment or establishments where they offer services, the notice of absence must be made no less than half an hour in advance before the beginning of the shift day.
  2. The applicant must inform the Faculty of Medical Sciences of the license and can use any of these routes to do so. Telephone access: 0800-888-2798, 0810-888-2798, 0341 4354305, 4351207. Via web: entering this links. The service is available from Monday to Friday from 7:00 a.m. to 7:00 p.m.

These channels facilitate the delivery of information by school personnel, on data related to their license requirement, the requirements vary whether or not they made a prior medical consultation.

Arrived here we will explain how to complete the form:

Option A) If the agent made a prior consultation with a private doctor:

  • Type of leave to request: personal illness, sick family member or maternity
  • Type and number of document
  • Last name and name
  • Physical location where the sick person is
  • Phone where you can be reached
  • Period and article/subsection of the corresponding license
  • Pathology or prescribed medical diagnosis
  • Surname, first name and registration number of the private doctor who attended you
  • In the case of leave to care for a sick relative: Surname and name of the relative, relationship and age of the relative

Important: If I make the report via the web, you must choose the option «Complete License Request». At the end of the data upload, the applicant will receive confirmation of the action carried out by receiving an email.

Option B) In the scenarios where the agent did not carry out a prior consultation with a doctor:

  • Type of leave to request: own illness, family illness, maternity
  • Type and number of document
  • Name and surname
  • Address where the sick person is
  • Telephone contact.
  • Period and article/subsection of the corresponding license
  • If the license is for the care of a sick family member: Name and surname of the family member, indicate the relationship and age.

Important: If you made your report using the web portal, you must select “Incomplete License Application”. At the end of the data upload, you will be confirmed by email.

You should know that if you fill out your form using option B, you have to attend a private doctor and then make a second communication, it must be done within 48 hours after the first notice, and you must report the missing data:

  • Type and number of document (based on this data, the operator recovers the procedure)
  • Prescribed medical diagnosis
  • Period and article/subsection of the corresponding license
  • Surname, name and license plate of the private doctor who attended you.

Important fact: If you load the data via the web, you must select the option «Complete License Request» and you will have to load all the fields again.

Please note:

If you do not make a second communication within 48 hours of the first notice, your request will not be processed, and therefore your leave will be considered unjustified.

About Form LM-01: It is required that the agent who requested it deliver the Form LM-01 to the private doctor so that he is the one who records the period of absence, the article and paragraph, and the pathology according to the CIE_10 nomenclator (see back of the LM- 01). The additional data requested must be completed by the applicant. Remember that you must fill out as many LM-01 forms as the number of establishments where you will be absent.

Final Step: To close the process, the requesting agent must deliver the following documents on paper to the educational establishment(s), this must be done within 72 hours of making the request:

  • Form LM-01 completed and signed by the doctor.

In addition, and in accordance with the license you have ordered:

  • Sick or Sick Family Leave: Stamped medical certificate, this requirement is excluded when the issuer of the certificate is a public health provider. Please note that only one certificate is required, regardless of the number of Forms LM 01 that you must submit.
  • Pre-delivery leave: Deliver pregnancy certificate, must include estimated date of delivery
  • Maternity leave: Deliver birth certificate
  • Sick Family Leave: Copy of the affidavit of the relatives in charge, must be signed by the address of the Establishment. Each form will be delivered by each establishment that corresponds to it. This requirement is part of the Teaching Staff Licensing Regulation (Decree 4597/83)
  • Leave for a sick family member of a disabled child: Copy of the certificate issued by the Directorate of Inclusion for People with Disabilities of the province

In addition, only in the cases of licenses for a sick family member, and only once, you must present said copies to the Faculty of Medical Sciences, by mail, scanned, to, or by Fax to 0341 – 4804556.

Personal illness. Complete license application

To carry out this procedure, school personnel can do so using the Health Prevention and Promotion System, this mechanism allows them to report their incidents via the Web and with this they will be able to comply with the norm that requires justifying their absences,

For this we invite you to give click here

Administrative license application methodology

Currently, a new methodology has been implemented to request administrative licenses. The basic requirement dictates that all agents must download the «LA» form, complete it and then present it to Personnel.

At this link, you can download the LA format

In this link You will find official information on the methodology required to opt for the administrative license.

Consult medical license application

All employees in the education sector will be able to check the status of their procedures online just by visiting the Santa Fe province portal.

The service will only be available to those who uploaded the data via the Web, and can be performed 48 hours after the initial request was uploaded.

check this link

We hope that all the information we have provided you will be useful to process your license! Regards.

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