The Complete Guide to Doctor's Notes for Work in the US: When You Need One, What It Must Say, and What Employers Can Legally Ask
The short answer (doctor's note for work)
A work doctor's note should prove only three things: the dates you could not work, what you could not do, and when you can return or be reviewed. Diagnosis, medication lists, and full medical history are not required for an ordinary sick note.
A work doctor's note should prove three things and no more: the dates you could not work, what you could not do, and when you can return or be reviewed again. This guide covers doctor's note for work in detail. Your diagnosis, medication list, and full medical history are not part of that proof for an ordinary sick note, and adding them usually creates privacy problems without making the note stronger.. If your leave reaches FMLA, an accommodation, or a state benefit program, the form and the proof change, so check which program you are actually in before you send anything.
Check yourself before you read further. Answer yes or no:
Do you know the exact dates you were out, including the first and last date?
Can you name one work task you could not do on those dates, in plain job language?
Do you have a return date or a review date written on the note?
Does your employer's written policy say a note is required for this length of absence?
Is your leave only a short sick absence, rather than FMLA, an accommodation request, or a state benefit claim?
If you answered yes to the first three, your note is close to ready to submit. If you answered no to question 4, you may not need a note at all for this absence. If you answered no to question 5, read the section on FMLA and state programs before you send the short note, because a short note alone will not carry that kind of claim.
Monday morning in HR: three notes, three different verdicts
According to the U.S. Department of Health & Human Services (HHS), proper medical documentation is essential for protecting your rights.
Dana Whitfield manages human resources for a 120-employee distribution company. On one Monday morning, three notes land in her inbox for three employees who were out the previous week. The three employees work different shifts, they have different jobs, and their notes look nothing alike. Dana does not decide based on how sick anyone sounds. She decides based on whether each note answers the three questions every work note must answer: which dates, what limits, and when back.
The first note reads: "Jordan was seen on March 3 and was ill." It has a provider name and a signature. It has no end date, no return date, and no statement about what Jordan could or could not do. Dana cannot put Jordan back on the schedule from that note. She does not know whether Jordan was out for one day or five days, and she does not know whether Jordan can lift, stand, drive, or sit at a desk. A date of a visit is not the same as a period of absence, and a word like ill does not tell a scheduler what to change.
The second note reads like a medical chart summary. It names the diagnosis, lists two medications, describes prior treatment, and ends with a broad line: "Please excuse the employee as needed." Dana now has information she did not need and information she cannot use. She still does not have a clear end date, she does not have a clear set of work limits, and the phrase as needed leaves the return date open. Worse, the extra medical detail now sits in a personnel file where it does not belong, and Dana must separate it, store it apart from ordinary personnel records, and limit who can see it. More detail did not make this note stronger. It made it harder to handle.
The third note reads: "Sam was unable to work March 3 through March 5. Sam could not stand for more than 30 minutes at a time and could not lift more than 10 pounds during that period. Sam is cleared to return to full duty on March 6, with a review on March 5 if symptoms return." That note gives Dana a start date, an end date, a functional limit in job language, and a return date. She can excuse March 3 through March 5, she can hold Sam off heavy lifting for those three days, and she can schedule Sam for full duty on March 6. She does not need Sam's diagnosis to do any of that work, and she does not ask for it.
That comparison is the whole guide in miniature. The strongest note is not the longest note, and it is not the most medical note. It is the note that lets the person who schedules work make a clear decision with the least private information.
This article is the pillar for work doctor's notes in the United States. It stays at the level of the decision: when a note is required, what it must say, what an employer can legally ask, and where the line moves when your leave becomes something bigger than a sick absence. The supporting articles in this cluster take one piece each: how many days you can take without a note, what happens when a note is rejected, how an employer verifies a note, and how return-to-work notes work in practice. This pillar does not repeat their full checklists. It gives you the verdict rule you can apply to any of them.
What a work note must say: dates, limits, return
Need medical documentation for your situation?
According to the ADA National Network, proper medical documentation is essential for protecting your rights.
A usable work note answers three questions in that order. If any one answer is missing, the note will stall, even if the rest of the note is perfect.
Dates. Write the first date you could not work and the last date you could not work. Write both dates, not only the date you saw a provider. A visit on March 3 does not prove you were out on March 4. If you worked part of a day, say which part. If your absence was intermittent, list the dates, not a range that hides gaps. HR counts absence by dates and shifts, not by visits.
Functional limits. Write what you could not do, in the language of your job. "Unable to stand for more than 30 minutes at a time" helps a scheduler. "Unable to lift more than 10 pounds" helps a warehouse lead reassign work. "Unable to sit at a computer for a full shift" helps a manager approve a reduced schedule. A diagnosis does not do that work. A diagnosis tells a reader what condition you have. A limit tells a reader what to change at work. For an ordinary sick note, the limit is the useful sentence, and the diagnosis is extra information that creates a privacy cost without adding a scheduling answer.
Return or review. Write a return date, a return with limits date, or a review date. "Cleared to return to full duty on March 6" closes the case. "Cleared to return with no lifting over 10 pounds until March 10, review on March 10" also closes the case for the period it covers. "Excuse as needed" never closes a case, because no one knows when needed ends. If your provider cannot give a firm return date yet, a review date is the next best answer, because it tells HR when to expect an update instead of leaving the absence open.
Add two identifiers that make verification possible without opening your medical record: the provider's name and practice, and a contact method HR can use to confirm that the note is real. That contact is for authenticity, not for your history. HR can confirm that a provider issued the note on the dates stated. HR does not need your chart, your lab results, or your treatment plan to confirm authenticity, and you should not attach those documents to a work note unless a separate program, such as FMLA certification or a disability claim, specifically asks for them on its own form.
Read your note once through Dana's eyes before you send it. Can a scheduler excuse the right dates from it? Can a scheduler change the right tasks from it? Can a scheduler put you back on the schedule on a specific date from it? If the answer to any of those three questions is no, fix that sentence before you send the note. Do not fix a missing return date by adding a diagnosis. Fix it by asking your provider for a return date or a review date.
Image 2: What a doctor's note for work must say: dates, limits, return
What employers can legally ask, and where the line stops
The legal line is narrower than most employees expect, and it is also narrower than some managers assume. The U.S. Equal Employment Opportunity Commission explains that, for current employees, disability-related inquiries and medical examinations are permitted only when they are job-related and consistent with business necessity. In practical terms, that means an employer must have a reasonable belief, based on objective evidence, that a medical condition will keep you from performing the essential functions of your job, or that it will pose a direct threat, before it can dig deeper than the ordinary note. Asking about your general well-being, or whether you can perform job functions, is not treated the same way as asking whether you have or ever had a disability, what prescription medications you take, or what your test results show. The first set of questions points at work. The second set points at a disability, and it needs a stronger justification.
The same EEOC guidance answers the sick-leave question directly: an employer may ask for a doctor's note or other explanation when you have used sick leave, as long as it has a policy or practice of requiring all employees to do so. That condition matters. A note requirement that applies to everyone for the same length of absence is different from a note requirement that appears only for one employee, or only after a manager learns something private about that employee. If your employer's handbook says a note is required after three consecutive days, and you were out for two days, the handbook itself is your first check. If your employer has no written rule and asks only you for a note after one day, ask for the rule in writing before you hand over medical detail. You are not refusing to prove an absence. You are asking which rule you are being measured against.
Confidentiality is the second half of the line. Medical information an employer obtains must be kept confidential, stored separately from ordinary personnel records, and shared only with people who need it to make a work decision. That rule is one reason a short note is safer than a long chart summary. A short note gives HR three work answers and nothing to separate, store, or accidentally forward. A long note forces HR to handle diagnosis and treatment history that it never needed for scheduling, and it creates a record that can follow you in ways a date and a limit never will.
The Americans with Disabilities Act adds a size threshold that many employees miss. The EEOC fact sheet on disability discrimination states that Title I of the ADA covers employers with 15 or more employees, including state and local governments. If your employer has fewer than 15 employees, federal ADA rules about medical inquiries may not apply in the same way, even though state law or your employer's own policy may still set rules. Do not assume a federal rule covers a 6-person shop, and do not assume a small employer can ask anything it wants. Check the size threshold, then check your state law and your handbook. The three checks together, federal threshold, state law, and written employer policy, give you the real rule for your job, and no single one of them alone is enough.
For a deeper look at how FMLA leave and job protection interact with medical documentation, see the guide on California CFRA vs. FMLA job-protected leave. That guide is written for California, where CFRA and FMLA overlap, but the FMLA eligibility and certification principles it explains are a useful next step once your leave is longer than a short sick absence.
When a short note is enough, and when it is not
Most work notes fail not because they are short, but because they are sent for the wrong program. A short note proves a short absence. It does not prove a longer protected leave, it does not prove a disability accommodation, and it does not prove a benefit claim. Sending the right document to the wrong program is the most common reason a note that looks fine gets returned with a request for a different form.
Use this list as a first sort, not as a final legal answer for your case. Each item points to the program that actually decides that kind of leave, and to the document that program expects.
Out 1 to 3 days, back to full duty, no ongoing limits. Decided by your employer's sick-leave policy and state sick-leave law. The program expects a short work note: dates, limits, return date.
Out more than a few days, or back with ongoing limits. Decided by your employer's policy, plus possible FMLA or accommodation review. The program expects a short note for the absence, plus a separate certification if FMLA or accommodation is invoked.
Need a changed schedule, a changed task, or equipment to keep working. Decided by the ADA reasonable accommodation process, for covered employers. The program expects accommodation documentation: functional limits tied to a specific requested change.
Need pay during a longer medical absence. Decided by your short-term disability policy or a state benefit program. The program expects claim documentation on that insurer's or program's form, not a short work note alone.
Caring for a family member, bonding with a child, or using a state paid leave program. Decided by FMLA, state family leave law, or a state paid leave program. The program expects a program certification: for FMLA, a certification form; for a state program, that program's form.
The FMLA row needs its own numbers, because FMLA eligibility is a threshold test, not a judgment call. The Department of Labor states that FMLA applies to private-sector employers with 50 or more employees in 20 or more workweeks in the current or previous calendar year, and to public agencies and local educational agencies regardless of size. An employee is eligible if the employee has worked for a covered employer for at least 12 months, has at least 1,250 hours of service during the 12 months before leave starts, and works at a location where the employer has at least 50 employees within 75 miles. Eligible employees may take up to 12 workweeks of leave in a 12-month period for a serious health condition that makes the employee unable to perform the functions of the job, among other qualifying reasons. If you do not meet those three eligibility tests, an FMLA certification form will not create FMLA protection for you, no matter how complete the form is. Check eligibility first, then choose the form.
The form most people meet at this stage is Form WH-380-E. The regulation that sets the content of FMLA medical certification, 29 CFR 825.306, states that an employer may require a certification that sets out the provider's name, address, telephone number, and type of practice; the approximate date the serious health condition commenced and its probable duration; a statement of appropriate medical facts sufficient to support the need for leave; and, when the employee is the patient, information sufficient to establish that the employee cannot perform the essential functions of the job, plus the nature of any work restrictions and their likely duration. The regulation also states that the Department of Labor has developed optional Form WH-380-E for the employee's own serious health condition and Form WH-380-F for a family member's condition, and that no information may be required beyond what the regulation specifies. That boundary is important for two reasons. One, your employer cannot use an FMLA form to collect your full medical history. Two, a short sick note is not a substitute for WH-380-E when FMLA is invoked, because WH-380-E asks for duration, medical facts, and work restrictions in a structured way that a one-line sick note does not.
A note about diagnosis on WH-380-E deserves precision, because it is where the diagnosis trap starts. The regulation asks for medical facts sufficient to support the need for leave, and it lists examples of medical facts that may include symptoms, diagnosis, hospitalization, doctor visits, whether medication has been prescribed, referrals, or a regimen of continuing treatment. The word may matters. The regulation does not list diagnosis as a standalone item that must appear on every certification, and it does not require you to hand over your chart. A provider can support a leave with facts about incapacity, treatment, and work restrictions without turning the certification into a diagnosis disclosure. If a form you are given demands a diagnosis field and nothing else will satisfy your employer, ask in writing which regulation or program rule requires that field for your specific leave, and keep the answer with your copy of the form.
If your leave overlaps FMLA, short-term disability, and a state paid leave program at the same time, do not send the same short note to all three and assume the overlap is handled. Each program has its own clock, its own form, and its own decision maker. The guide on fast-track medical leave approval for FMLA, STD, and PFML walks through that sequencing, and it is the right next read once you know you are in more than one program. This pillar's job is to stop you from sending a short note into a multi-program leave and discovering, weeks later, that none of the programs counted it.
The California example: same note, different programs
California shows why a national rule and a state rule must never be merged into one sentence. A California employee can face three different systems for one absence: the employer's sick-leave policy, California's paid sick leave rules, and a state benefit program such as Paid Family Leave or State Disability Insurance. The short note proves the absence to the employer. It does not, by itself, prove a PFL claim or an SDI claim, because those programs have their own eligibility rules, their own forms, and their own decision maker, the Employment Development Department.
For family care under California Paid Family Leave, the EDD eligibility guidance confirms several points that employees often get wrong: part-time work during leave is allowed with reporting, care outside California is allowed if the provider certifies and holds a verifiable license, and more than one family member can file for the same event only for different, non-overlapping periods. Those points are California PFL points. They are not national work-note rules, and they should not be copied into a note for a job in Texas or Ohio. Use California examples only when your job and your claim are in California, and keep the state label on every California sentence you write.
Two California guides in the Havellum library are the right next reads for California readers, and only for California readers. The California SDI and PFL 2026 guide on SB 951 and higher benefits explains the state benefit programs at overview level, and the California SDI 2026 doctor's note and medical certification guide explains what medical certification looks like for a California SDI claim. If you are not in California, skip both guides for now and stay with the national rule in this pillar, plus your own state's sick-leave law. A California benefit amount, a California filing window, or a California form name in a non-California note is not extra proof. It is a signal that the note was written for the wrong program.
How to ask your provider for a note that passes Dana's test
Most notes fail in the exam room, not in HR, because the patient asks for the wrong thing. Patients often ask, "Can you write me a note that says I was sick?" Providers often answer with a visit confirmation, because that is what was asked for. Ask for the three answers instead, in plain language, before the visit ends.
Say this, in your own words: "I need a work note that my scheduler can use. Could you write the dates I could not work, what work tasks I could not do on those dates, and the date I can return or the date you want to review me again? Please keep it to limits and dates, and leave out my diagnosis and medication list unless a specific program form asks for them."
Image 3: How to ask your provider for a doctor's note that passes test
That request does three things. It tells the provider you need a work document, not a visit receipt. It tells the provider the three sentences HR needs. It also gives the provider a reason to leave out extra detail, which protects you and makes the provider's job easier, because the provider does not have to decide what to include from your chart.
If the provider's system prints a standard note that only shows the visit date, ask for an add-on line before you leave. A one-line add-on, written and signed by the provider, can fix a date-only note: "Unable to work March 3 through March 5. Unable to lift more than 10 pounds. Return to full duty March 6." Do not add that line yourself after you leave, and do not ask a family member to add it. A note you edit yourself loses its verification value the moment HR compares it to the provider's record.
If you do not have a regular provider, or you cannot get an appointment before your return date, an online assessment can be a practical path for a short, straightforward absence, as long as you understand what it can and cannot do. Havellum's process is online assessment, licensed provider review, and, if appropriate, a document issued to your account. That process fits a short note when the assessment can establish dates, limits, and a return date from the information you provide and the provider's review. It does not fit a case that needs an in-person examination, a test, or a long treatment record, and it does not replace an FMLA certification, a disability claim form, or a state program form. When you use any online path, keep the same three-sentence test: dates, limits, return. If the document you receive does not pass that test, do not send it and hope HR fills in the gaps. Ask for the missing sentence through the same provider channel before you submit.
For parental leave, the same three-sentence test applies, but the program changes again. Bonding leave, pregnancy-related limits, and postpartum return each have their own proof, and the U.S. parental leave guide on FMLA and paid policies in 13 states is the right next read if your absence is for a new child rather than for your own short illness. Do not send a short sick note for a bonding leave and expect it to carry a parental claim. The claim needs its own form and its own dates.
The one pitfall to study in depth: the diagnosis trap
Every other mistake in this guide has a quick fix. The diagnosis trap does not, because it feels like the safe choice and it harms you in three ways at once. Study this pitfall carefully, because it is the one most employees repeat, and it is the one most likely to follow you after the absence ends.
The trap works like this. You worry HR will not believe you, so you hand over more proof than HR asked for. You include the diagnosis, you include the medication list, you include a prior visit summary, and you think, "Now they cannot doubt me." HR now has a stronger impression of your condition, but a weaker work document, because the extra pages do not answer the scheduling questions any better than the three sentences would have. HR must now store diagnosis and treatment information separately, limit who sees it, and answer questions about why it was collected. If a later decision, such as a promotion, a schedule change, or a second leave request, touches that file, the extra information is already there, and you cannot unshare it.
The second harm is scope creep. Once HR has a diagnosis, the next question often becomes a medical question, not a work question. "How long will this condition last?" "Will it come back?" "Can you do this job at all?" Those questions belong to an accommodation process or an FMLA certification process, where they have forms, deadlines, and limits. When they arrive through a short sick note, they arrive without those protections, and employees often answer them in an email, off the record, before they realize they have entered a different process. A short note that only states limits and dates keeps the conversation in the sick-leave lane. A diagnosis-heavy note invites the conversation into the accommodation lane before you have chosen to enter it.
The third harm is the return-to-work problem. A diagnosis-heavy note that ends with "excuse as needed" or "until cleared" gives HR no return date to schedule against, and it gives you no clear end to the absence. HR may keep you off the schedule longer than necessary, or may schedule you back before you are ready, because neither side has a date to point to. A limit-and-date note solves both problems at once: it excuses a defined period, it defines what you cannot do during that period, and it names the date the period ends or the date you will be reviewed again.
Fix the trap at the source, not after you send the note. Before you submit, read the note and cross out, in your mind, every sentence that is not a date, a limit, or a return or review date. If the note still answers Dana's three questions after you cross out the extra sentences, send the short version. If it does not answer them, ask your provider for the missing date or limit, not for more diagnosis. If a specific program form, such as WH-380-E for FMLA, asks for medical facts, answer that form on its own terms, with facts sufficient to support that program's need, and keep that form separate from your ordinary sick note. Do not merge the two documents into one long note and send the merged version to everyone. Different programs, different forms, different recipients. That separation is the privacy protection, and it is also the proof protection, because each decision maker gets exactly the proof its program asks for, and nothing extra to misread.
If your employer asks for more, or rejects the note
A rejection is not always a final answer, and a request for more information is not always an overreach. Read the rejection or the request the same way Dana reads a note: what exact sentence is missing, and which program is asking for it?
Start with the written reason. If HR says the note is missing an end date, that is a fixable gap: ask your provider for an end date or a review date. If HR says the note is missing work limits, that is also fixable: ask your provider to add the specific task limits. If HR says the note is not from a verifiable provider, check the provider name, practice, and contact method on the note, and confirm through the provider's own channel that the contact method is current. If HR gives no written reason, ask for one in writing, in a short message: "Could you tell me in writing which item is missing from my note, so I can ask my provider for that item?" That message protects you, because it turns a vague rejection into a specific checklist, and it protects HR, because it gives HR a clear record of what was requested.
Do not respond to a rejection by sending your full medical record. A full record contains far more than the missing item, and it creates the diagnosis trap a second time, under pressure. Send only the missing item, through the same provider channel, and keep a copy of what you sent and when you sent it. If HR asks for a diagnosis, a medication list, or your treatment history for an ordinary sick absence, ask in writing which policy, state law, or program form requires that item for this specific absence. Keep the answer with your copy. If the answer points to FMLA certification, an accommodation process, or a benefit claim, switch to that program's form and its rules, rather than expanding your sick note to meet a different program's standard.
If your note was rejected and you need the detailed rejection playbook, the supporting article on employer rejection in this cluster takes one rejection letter and breaks it down by reason. This pillar does not repeat that playbook here, because this pillar's job is the verdict rule, and the rejection article's job is the repair steps for each reason. Read the rejection article next only if you have a rejection in hand. If you do not have a rejection, your next step is the checklist below, not another article.
For readers who need a work note for the United States in general, the doctor's note for the USA hub is the entry point to Havellum's U.S. work-note coverage, including the supporting articles in this cluster. Start there if you arrived at this pillar from a search and want to see the full cluster map before you choose your next article.
Your pre-submit checklist
Do this check in order, on the note itself, before you send it to anyone. Do not send first and check later, because a sent note cannot be unsent from a personnel file.
Dates: Does the note state the first date you could not work and the last date you could not work, matching the shifts you missed?
Limits: Does the note state at least one work task you could not do, in job language, for those dates?
Return: Does the note state a return date, a return with limits date, or a review date?
Provider: Does the note show a provider name and practice and a contact method HR can use to confirm authenticity?
Privacy: Have you removed every sentence that is not a date, a limit, a return or review date, or provider identification, unless a separate program form specifically asks for it?
If you can check all five, your note is ready to submit. If you cannot check one, fix that one item through your provider before you submit. That single check is the action this article leaves you with: before you send any work note, run the five lines above on the note itself, and do not let a missing return date be fixed by adding a diagnosis.
Frequently asked questions
Do I need a doctor's note for one sick day?
Not always. It depends on your employer's written policy and your state sick-leave law, and on whether the absence is a short sick absence or a longer program leave. Check the written policy first. If the policy requires a note only after a set number of consecutive days, and you were out for fewer days, you may not need a note for this absence. If the policy requires a note for any absence, submit a note that states dates, limits, and a return date.
Can my employer call my doctor to verify my note?
Your employer can confirm authenticity through the provider contact on the note, meaning it can confirm that the provider issued a note for the dates stated. That verification is not a right to obtain your medical record, your diagnosis, or your treatment history. Keep provider identification on the note and keep your medical record separate from the work note.
Do I have to tell my employer my diagnosis?
For an ordinary sick note, no. The note needs dates, functional limits, and a return or review date. A diagnosis is not a scheduling answer, and adding it creates privacy handling that a short note avoids. For a specific program form, such as FMLA certification, the form asks for medical facts sufficient to support that program's need, and that is a separate form with its own limits, not an expansion of your sick note.
What should I do if my employer rejects my note?
Ask for the missing item in writing, fix only that item through your provider, and keep a copy of what you sent and when. Do not send your full medical record in response to a rejection. If the missing item belongs to a different program, such as FMLA or an accommodation, switch to that program's form.
Does a telehealth note count the same as an in-person note?
It can, when the assessment and the provider review can establish dates, limits, and a return date, and when the note shows a verifiable provider. An online assessment fits a short, straightforward absence. It does not replace an in-person examination, a test, a long treatment record, an FMLA certification, or a state program form when those are specifically required.
What is Form WH-380-E, and do I need it for a short sick note?
Form WH-380-E is the Department of Labor's optional certification form for an employee's own serious health condition under FMLA. You do not need it for an ordinary short sick note. You need it, or an employer form containing the same basic information, when FMLA is invoked and the employer requires certification for a serious health condition.
Does FMLA require me to disclose my diagnosis?
FMLA certification asks for medical facts sufficient to support the need for leave, plus work restrictions and duration, under 29 CFR 825.306. That regulation lists medical facts that may include diagnosis, among other examples. It does not turn diagnosis into a standalone mandatory disclosure on every certification, and it does not require you to hand over your full chart. Answer the specific form for your specific leave, and keep that form separate from your ordinary sick note.
I work in California. Does this guide still apply to me?
The national verdict rule in this guide applies: dates, limits, and return date, with diagnosis kept out of an ordinary sick note. California adds its own programs, such as Paid Family Leave and State Disability Insurance, with their own forms and their own decision maker. Use the California guides linked in this article for a California benefit claim, and do not copy a California program rule into a non-California note.
This article provides general information only and is not legal, tax, or medical advice. Rules vary by employer policy, state law, and program, so check the written policy and the specific program form that applies to your leave before you submit.
Further Reading
Official Resources
U.S. Equal Employment Opportunity Commission, Questions and Answers: Enforcement Guidance on Disability-Related Inquiries and Medical Examinations Under the ADA — https://www.eeoc.gov/laws/guidance/questions-and-answers-enforcement-guidance-disability-related-inquiries-and-medical
U.S. Equal Employment Opportunity Commission, Fact Sheet: Disability Discrimination — https://www.eeoc.gov/laws/guidance/fact-sheet-disability-discrimination
U.S. Department of Labor, Family and Medical Leave Act — https://www.dol.gov/agencies/whd/fmla
29 CFR 825.306, Content of medical certification for leave taken because of an employee's own serious health condition or the serious health condition of a family member — https://www.law.cornell.edu/cfr/text/29/825.306
California Employment Development Department, FAQ: Paid Family Leave Eligibility — https://edd.ca.gov/en/disability/FAQ_PFL_Eligibility
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