Sick Notes in China: A Foreigner's Medical Certificate Guide

Short answer: A foreign employee who needs a sick note in China should first ask the employer what document it accepts, then visit an appropriate licensed medical institution and tell the treating doctor that a medical diagnosis or sick-leave certificate is needed. The doctor must base the document on an actual consultation and medical record. Many institutions require the signed certificate to be reviewed, registered and stamped at a designated hospital desk before it is valid. Procedures, accepted issuers, submission deadlines and privacy requirements vary, so confirm them with both the hospital and employer.

A hospital document can record a diagnosis, treatment and clinically recommended rest period. It does not by itself settle every employment-law question or guarantee that an employer will approve a particular form of paid leave. This guide covers the medical-document workflow, not individualized medical or legal advice.

Why foreign employees find the process confusing

Recent public Reddit discussions repeatedly ask whether a foreign employee needs a hospital note for one day of illness, whether a coworker or HR representative must accompany the patient, which hospital level is accepted, whether a stamped outpatient record is enough, and how much medical information an employer may request. Other patients report completing tests but leaving without the specific certificate their employer expected.

These discussions reveal a practical information gap, but Reddit anecdotes do not prove hospital policy, employer rights or legal outcomes. China does not use one nationwide form for every ordinary medical certificate. National Health Commission guidance says that, where no national or local standard form exists, each medical institution should establish its own issuing rules, format, authorized personnel, numbering and record-retention process.

The safest approach is to align three things before submission

the employer's written document requirement;
the hospital's official certificate process; and
the minimum medical information necessary for the stated purpose.

Know which document you are asking for

Document	What it usually records	Why it may not be enough by itself
Outpatient or emergency medical record	Visit date, history, examination, diagnosis and treatment notes	It may not contain a specific recommendation to rest or the hospital's certificate stamp
Medical diagnosis certificate (`诊断证明书`)	A diagnosis or medical conclusion based on the consultation	The employer may also request a recommended rest period or a separate sick-leave certificate
Sick-leave or rest certificate (`病假证明` / `病休证明`)	A clinician's recommendation that the patient rest for a stated period	The hospital recommendation does not replace the employer's leave procedure
Discharge record (`出院记录`)	Admission, inpatient care, discharge diagnosis and follow-up information	The employer may require a stamped copy or a separate certificate
Test report, prescription or payment receipt	Evidence of a test, medicine or payment	It does not necessarily prove that a clinician recommended absence from work

Names and formats differ by institution. Do not assume that a registration receipt, laboratory result or prescription is the same as a sick note. Ask the employer for the required Chinese document name or a sample with personal details removed.

Step 1: ask the employer what it will accept

Before visiting a hospital—if your condition allows—request the sick-leave policy in writing. Useful questions include:

Is a certificate required from the first day, or only after a stated number of days?
Must it come from a public hospital, a particular hospital level or a designated provider?
Is a community health center or licensed clinic accepted?
Does the document need a clinician's signature, a hospital seal, or both?
Is the original required, or will a scan or electronic certificate be accepted?
What is the submission deadline?
Is a diagnosis required, or is a recommended rest period sufficient?
Is an English translation needed, and who may prepare it?
Which HR role receives the document, who may access it and how long is it retained?

An employer's internal rule is not automatically a statement of national law. If a requirement affects pay, discipline, privacy or employment status, ask HR to identify the contract, lawful workplace rule or legal basis and seek qualified labor-law advice where necessary.

Step 2: choose the appropriate medical institution

The National Health Commission's medical-institution regulations prohibit an institution from issuing a disease diagnosis or health certificate without a clinician personally examining the patient. A certificate therefore begins with a real clinical visit, not a request for paperwork alone.

Use the employer's accepted-provider rule and the hospital's official information to choose a facility. ChinaMedGuide's China hospital directory and city pages for Beijing, Shanghai, Guangzhou and Shenzhen can help organize options. A hospital profile such as Peking Union Medical College Hospital and a specialty page such as cardiology are orientation resources, not proof that a particular certificate will be issued.

For a routine outpatient problem, confirm whether the employer accepts a nearby licensed institution rather than assuming a crowded tertiary hospital is required. For severe or urgent symptoms, prioritize appropriate medical care rather than document convenience. The hospital registration guide explains passport registration and appointment basics.

Step 3: tell the treating doctor what document is needed

At registration or during the consultation, say clearly that you may need a medical diagnosis certificate or sick-leave recommendation for your employer. Bring:

the passport used for hospital registration;
the exact Roman-letter name used by your employer;
the employee policy or required document name;
relevant prior records and current medicines; and
a reliable way to communicate clinical information.

The clinician decides what diagnosis, treatment and rest recommendation is medically supportable. National guidance requires medical certificates to be specific, truthful, reasonable, clear and consistent with the institution's records. A clinician should not issue a false document, one unrelated to the clinician's professional scope, or one for a person who was not seen at that institution.

Do not ask a doctor to change dates, extend rest without medical basis, omit a material identity error or issue a certificate for someone else. Altering a certificate or stamp can create employment, medical and legal problems.

Step 4: complete the hospital's review and stamping process

A doctor's signature may be only the first step. National guidance requires institutions to control certificate authorization and seals. Local official service guides commonly describe a sequence such as:

the treating clinician writes and signs the certificate;
the patient takes it with the medical record and identification to a designated outpatient, medical-affairs or service desk;
staff check the document against hospital requirements; and
the hospital registers and applies the designated seal.

The exact desk and office hours vary. Qingdao Municipal Hospital, for example, publishes a same-day outpatient process in which the treating doctor issues an electronic diagnosis or sick-leave certificate and a hospital service center prints, reviews, registers and stamps it. That hospital also states that outpatient sick-leave certificates cannot be issued retrospectively. This is an institution-specific example, not a nationwide rule.

Before leaving, check:

passport name and number;
visit and issue dates;
clinician name and signature;
diagnosis or clinical conclusion, if included;
recommended rest period, if included;
hospital name and designated seal;
whether pages or attachments need matching stamps; and
how authenticity can be verified without exposing the complete record.

Photograph or scan the completed document and keep the original flat and legible. Use the medical-records guide if you also need outpatient notes, test reports or a discharge record.

Step 5: handle passport names and translation carefully

Foreign employees can encounter mismatches between the passport, hospital record, work permit and employer system. Ask the hospital to use the identity name it can verify from the passport. Do not manually rewrite the name on a completed certificate.

If the employer needs English, ask whether it accepts:

the original Chinese certificate alone;
a hospital-issued bilingual certificate;
the Chinese original plus an informal reference translation; or
the Chinese original plus a translation from a specified provider.

Do not assume that an English-language hospital webpage guarantees an English certificate. Keep the Chinese original as the controlling document unless the receiving organization states otherwise. The medical translation guide and medical phrase tool can help with navigation, but complex clinical communication or formal translation may require a qualified professional.

Step 6: share the minimum necessary information

China's Personal Information Protection Law classifies medical and health information as sensitive personal information. It generally requires a specific purpose, sufficient necessity and strict protective measures for processing it. The law also recognizes circumstances in which information may be processed when necessary to implement lawful human-resources management rules, so privacy questions cannot be reduced to “consent is always required” or “the employer may see everything.”

Ask HR

Why is each requested item necessary for leave administration?
Is the certificate enough, or is the full outpatient record really required?
Who will see the diagnosis and supporting records?
Where will files be stored and when will they be deleted?
Will the information be transferred to an insurer or another service provider?
Is there a less intrusive way to verify authenticity?

National medical-record rules require medical institutions and staff to protect patient privacy and prohibit unauthorized access. They also provide a process for patients or authorized agents to request copies of specified records. An employer or coworker does not automatically gain access to the complete hospital record merely by accompanying the patient.

If a coworker helps with registration or translation, state which assistance you consent to. Ask to speak with the clinician privately for any part of the consultation you do not want the companion to hear. Hospital safety, communication and local procedures may affect what is practical; obtain legal advice if an employer makes accompaniment a condition of leave or demands information you believe is excessive.

Step 7: submit a clean verification packet

Provide only the items the accepted process requires. A practical packet may contain:

the stamped diagnosis or sick-leave certificate;
a clear scan of the original;
a translation if specifically required;
the outpatient or discharge record only where necessary;
a short cover note identifying the leave dates; and
the hospital's public verification telephone number or official channel, if available.

Do not send a full laboratory history, imaging archive or unrelated diagnosis merely because it is easy to export from an app. Keep proof of when and how you submitted the packet.

Employers may have legitimate reasons to verify whether a document is authentic. A 2026 Shanghai human-resources authority case discussion says review should be cautious and should not infringe personal privacy or access to medical care. Verification of authenticity is different from giving an HR representative unrestricted access to the consultation or complete medical record.

What if you forgot to request the certificate?

Contact the issuing hospital immediately. Ask whether the treating clinician can issue or replace the document from the original medical record, which department handles the request, whether you must attend in person, and what identification or authorization is needed.

Do not assume a certificate can be backdated. Local and hospital rules differ, and some institutions explicitly prohibit retrospective outpatient sick-leave certificates. If the hospital cannot issue the requested document, collect the available contemporaneous evidence—such as the outpatient record, test reports, prescription and receipt—and ask the employer whether it will accept an alternative. Do not claim that those records are automatically equivalent.

Sick-note preparation checklist

[ ] I obtained the employer's written document and deadline requirements.
[ ] I confirmed which licensed institutions and document formats are accepted.
[ ] I used my passport name consistently.
[ ] I told the treating clinician that a work certificate may be needed.
[ ] The certificate matches the actual consultation and medical record.
[ ] I completed any hospital review, registration and stamping step.
[ ] I checked the dates, rest period, signature and seal before leaving.
[ ] I retained the original and a clear scan.
[ ] I confirmed whether a translation is required.
[ ] I asked HR to limit collection and access to necessary health information.
[ ] I kept evidence of submission and any employer response.

ChinaMedGuide's hospital navigation consultation can help organize facility, department, identity, document and communication questions. It cannot diagnose an illness, order a rest period, issue a medical certificate, decide an employment dispute or guarantee that an employer will accept a document. Our editorial and hospital data methodology explains how official evidence is separated from institution-specific procedures.

Frequently asked questions

Can a foreign employee get a sick note from a hospital in China?

Yes, a licensed medical institution may issue an appropriate medical certificate after a clinician examines the patient, subject to the institution's rules and the medical evidence. Confirm which document and issuer the employer accepts. Foreign status does not remove the need for a genuine consultation.

Do I need a public hospital sick note?

That depends on the employer's written policy, contract and applicable rules. Some employers specify a public hospital, hospital level or designated provider; others accept documents from any licensed medical institution. Ask before the visit when possible and seek legal advice if the requirement is disputed.

Is a doctor's signature enough?

Not always. Many institutions require review, registration and a designated hospital seal after the clinician signs. Ask where the certificate must be stamped and whether the desk has limited hours.

Can the hospital issue a sick note without seeing me?

A medical institution may not issue a disease diagnosis or health certificate without a clinician personally examining the patient. Internet-hospital or follow-up processes may have their own eligibility and document rules; confirm them with the provider and employer rather than assuming an online message is sufficient.

Can a sick note be backdated?

Do not assume so. National guidance requires certificates to be based on the actual visit and supporting record, while local and hospital replacement rules vary. Some hospitals explicitly state that outpatient sick-leave certificates cannot be issued retrospectively. Contact the treating institution promptly.

Must a coworker or HR representative accompany me?

There is no single hospital-document rule requiring every foreign patient to bring an employer representative. An employer may have an internal verification or assistance policy, but accompaniment does not automatically authorize access to the private consultation or complete record. Clarify the purpose, consent boundaries and legal basis.

Does my employer need the full diagnosis and medical record?

Not automatically. Medical information is sensitive personal information. Ask what information is necessary for leave administration, who will access it and whether a stamped certificate or rest recommendation is sufficient. Specific rights and duties depend on the employment arrangement and applicable law.

Will a prescription or payment receipt prove sick leave?

It proves a transaction or treatment item, not necessarily a clinician's recommendation that you should not work. Submit it only if the employer accepts it or needs it as supporting evidence.

Can I submit an English translation instead of the Chinese original?

Ask the employer. A translation can help the recipient understand the document, but it may not replace the signed and stamped Chinese original. Confirm whether the translation must come from the hospital or another specified provider.

Official sources and verification note

This article was verified on October 19, 2026 against the following primary official sources:

Hospital certificate names, issuing desks, stamp requirements, office hours and replacement rules can change. Employer policies and labor-law consequences depend on the specific facts and jurisdiction. Confirm current requirements with the hospital and employer, and obtain qualified legal advice for a dispute. Reddit was used only to identify recurring questions; no anecdote was used as factual evidence, and no username or identifiable personal detail is included.

Medical and legal disclaimer: This article provides general navigation information. It is not medical diagnosis, a rest recommendation, employment-law advice or a determination of privacy rights in a specific case.