Services
Doctor's note online in Puerto Rico, included with your visit
A doctor's note online in Puerto Rico, for work or school, is included at no extra charge when the doctor evaluates you by video and considers it appropriate. Book a US$79 doctor visit for your health problem; at the end, Dr. Diana Nieves Castro, a Puerto Rico-licensed physician, gives you a note dated the day of the visit with any rest she recommends. We see adults and children of all ages.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Chest pain or pressure
- Trouble breathing
- A drooping face, weakness on one side or trouble speaking
- A serious injury or bleeding that won't stop
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Doctor's note online in Puerto Rico: what it is and when you get one
A doctor's note states that the doctor evaluated you and, if needed, how many days of rest she recommends. You get it after your video visit, when the doctor considers it appropriate based on what she evaluated.
It isn't sold on its own: it's part of your visit. That way your employer or school gets a document that reflects a real medical evaluation.
How we evaluate you by video
The doctor asks about your symptoms, when they started and how they affect you, and has you show her what matters on camera, whether it's a cold, the flu, a stomach bug or back pain. She explains what's going on and how to take care of it. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. And if you need rest, she gives you your doctor's note.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your note in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request a doctor visit and pay by card.
You are charged when you request it, with a full refund if the visit can't take place.
We confirm your time and send your secure video link.
It works on your phone, tablet or computer.
The doctor evaluates you
and, if she considers it appropriate, gives you a doctor's note dated the day of the visit.
Price: the note is included
A doctor's note after your visit is included at no extra charge. You pay for the visit, not the document: a US$79 doctor visit for your health problem, or whichever visit fits what you need. If you're sick with something that isn't an emergency, see urgent care by video.
Video visit
Doctor visit
US$79
For a new problem, urgent care (non-emergencies), primary care, children, birth control, STIs, skin and acne, and visitors. Includes a doctor's note if you need one.
- You’re charged when you request the visit.
- Full refund if the visit can’t take place
A doctor's note for work in Puerto Rico
Puerto Rico's Vacation and Sick Leave Act (Ley 180-1998, as amended) lets an employer require medical certification when a sick absence runs longer than two working days (Art. 4, subsection o). The same applies when you are off to care for a sick child, spouse or parent.
Your employer's own policies or a union agreement may add details, and different rules may apply if your employer is on the mainland. If you're unsure what document you need, ask HR before the visit.
Notes for school or college
Puerto Rico public schools ask for a sick absence to be excused with a written note signed by the parent or guardian, handed in within 5 days of the absence, under the Department of Education's attendance regulation. A school can still ask for medical certification, for example when health-related absences keep recurring. Private schools, daycares and universities set their own rules.
If your child needs a doctor's note, a parent with patria potestad (parental authority) or a legal guardian must stay on camera for the whole visit. See online doctor visits for kids.
What the note says
The note reflects what the doctor evaluated during your visit:
- The date of the visit and that a Puerto Rico-licensed physician evaluated you by telehealth.
- The rest she recommends, if she considers it appropriate.
- It carries the date of the visit: we don't backdate notes or certify days the doctor couldn't evaluate.
Need a different document?
If you've been asked for a school, university or job medical form, see the work and school medical certificate. To tell the documents apart, read our guide to medical certificates in Puerto Rico. If it's for travel insurance or an airline, read about a doctor's note for travel insurance.
When to go to the ER
If you have chest pain, trouble breathing, signs of a stroke or a serious injury, don't wait for a visit: call 911.
Book your visit and get your note
Book a visit and choose Doctor visit (US$79) for the health problem that kept you home. Your doctor's note, if the doctor considers it appropriate, is included.
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
How much does a doctor's note cost?
What should a doctor's note say?
Can I get a note without a visit?
Can the note cover the days before my visit?
Does my child need a doctor's note for a Puerto Rico public school?
Need a doctor’s note?
US$79Doctor visit
- A doctor's note after your visit is included at no extra charge.
- You’re charged when you request the visit.
- Full refund if the visit can’t take place
Request a visit online 24/7 — we confirm your time by email or text.
Doctor visit (note if appropriate): US$79 — BookAbout this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-02
Sources (3)
- Ley 180-1998, Vacation and Sick Leave Act, as amended, Art. 4(o) (OGP, Spanish) (opens in a new tab) (accessed 2026-09-30)
- Student and Attendance Regulation, rev. 2022 (Puerto Rico Department of Education, Spanish) (opens in a new tab) (accessed 2026-09-30)
- Puerto Rico Telemedicine and Telehealth Act, Ley 168-2018 (LexJuris, Spanish) (opens in a new tab) (accessed 2026-09-30)