Last Updated: September 2026

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Best Ways to Get a Doctor's Note Online in San Francisco (2026)

Quick Answer

Check the local rule before you pay anyone: San Francisco's Office of Labor Standards Enforcement deems an employer policy that requires a doctor's note for three or fewer consecutive workdays of paid sick leave unreasonable (OLSE Rule 2.3), so a one- or two-day absence in the city usually needs no paperwork. When you do need documentation (a fourth day, a scheduled appointment, unpaid leave, or an employer outside SF), Kaiser San Francisco members get a video visit or e-visit note at $0 on most plans, UCSF patients can ask through MyChart, and cash payers can book a same-day Sesame Care video visit from about $34 that includes the note when the clinician finds it appropriate. Momentary is for people who want an ongoing California physician rather than a single visit: $19.99 a month for San Franciscans and other California residents, message your doctor any hour, and the physician can document a visit when clinically appropriate. Nothing legitimate hands over a note without an evaluation first.

Momentary is our own product. It is fourth because a monthly membership is the wrong purchase for someone who needs one note before a 9 am shift and nothing more.

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Top Picks

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Comparison Table

Prices verified September 2026. Every service leaves the decision to issue a note to the clinician.

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Why People Search for a Doctor's Note Online in San Francisco

Most searches happen the morning after a fever, with a manager, professor, or attendance clerk asking for proof. Three facts about working and studying in San Francisco change what you actually need.

SF caps note demands more tightly than the state does. Statewide, SB 616 guarantees at least 40 hours or five days of paid sick leave a year, and the Labor Commissioner's position is that an employer generally cannot deny it for lack of medical certification. San Francisco puts numbers on it: OLSE Rule 2.3 deems a note requirement unreasonable for three or fewer consecutive workdays and reasonable for more than three, full or partial. Employers may still verify a medical appointment (Rule 2.5) or act on a pattern or clear instance of abuse (Rule 2.4), and may not ask for a diagnosis or more detail than needed (Rule 2.1). The ordinance covers anyone working 56 or more hours a year in the city, at one hour accrued per 30 worked.

Hourly workers may already have money for the visit. The Health Care Security Ordinance requires employers with 20 or more employees (50 for nonprofits) to spend $4.11 an hour (100 or more employees) or $2.74 (20 to 99) on health care in 2026 for staff working 8 or more hours a week in SF. Contributions to the SF City Option become an SF Medical Reimbursement Account, and its eligible-expense list names telehealth consultations by live video, text, or email. A Sesame visit or a Momentary membership may be reimbursable; check the list.

SFUSD does not want a note for a sick day. The district's handbook, updated July 2026, says families do not need to submit a doctor's note for an illness absence to count as excused; a ParentVue notification, email, call, or signed parent note suffices. Only when illness absences or tardies exceed 10% of school days may an administrator request medical verification going forward.

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How We Ranked This List

We weighed the cash cost of one visit, whether it bills insurance or Medi-Cal, how fast a San Franciscan reaches a licensed clinician, whether the service already holds your chart, and how plainly it states its documentation rules. One-off options lead because a single note is what most people typing this phrase need, and Kaiser and UCSF sit above the national brands because so much of the city is already a patient of one or the other and the note costs nothing extra. Momentary is our own product; it is fourth because it suits someone who wants a physician to message any hour and who documents visits as part of continuous care, not someone buying one note. ZSFG is the in-person fallback for uninsured residents and Healthy San Francisco participants. We excluded GoodRx Care, which does not offer notes, Cedars-Sinai Connect, which is built around Los Angeles clinicians, and every site that sells a note without a clinician evaluation.

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Ranked Recommendations

1. Sesame Care — a same-day video visit from about $34 with the note built in

Why it's included: Sesame lists independent California-licensed clinicians with their own prices and open slots, many within the hour, and has a dedicated doctor's-note booking flow; the clinician documents the visit at no added cost when the symptoms and timeline support it. The site's headline is "from $37," same-day listings we observed ran $34 to $55, and San Francisco listings tend toward the top of that range. Costco members get $29 virtual primary care visits; Sesame Plus ($10.99 a month or $99 a year) discounts repeat use.

Best for: Cash payers in SF who need documentation for work or school today.

Pricing: From about $34 per video visit, provider-set; HSA/FSA cards work, and an SF MRA may reimburse the fee.

Limitations:

• A different clinician each time, with no access to your prior records
• No clinical basis means no note and no refund

When to choose something else: Your own system at $0 if you are a Kaiser or UCSF patient; Momentary if you want a doctor for the year rather than the day.

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2. Kaiser Permanente San Francisco — Get Care Now video or an e-visit note, $0 on most plans

Why it's included: Kaiser is the largest health system in the city, and members never have to leave kp.org. Get Care Now offers 24/7 video and phone visits statewide, and the e-visit questionnaire can generate a work or school note without a live visit under published rules: three days at most, never dated in the past, no more than once every eight weeks, and only if the clinician agrees. E-visit replies usually arrive within two hours between 7 am and 7 pm in Northern California. The San Francisco Medical Center at 2238 Geary Blvd has an urgent care for anything needing hands-on evaluation (check kp.org for hours); the Mission Bay Medical Offices at 1600 Owens St do not.

Best for: Kaiser San Francisco members, full stop.

Pricing: $0 for Get Care Now and e-visits on most plans, though some carry a video-visit copay. Northern California advice and appointment line: 1-866-454-8855.

Limitations:

• Closed to non-members
• An e-visit note runs out at three days; day four needs a video or in-person visit

When to choose something else: Non-members should use their plan's telehealth vendor, UCSF if they are a patient there, or Sesame.

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3. UCSF Health through MyChart — a message, e-visit, or Express Care video for existing patients

Why it's included: If your primary care is at UCSF, the Messages menu in MyChart offers Message your Provider and Request eVisit, and a work or school note request fits either. Most messages are free, but since November 14, 2021, UCSF may bill a message as an e-visit when it requires clinical assessment, a medication or test order, a form, or more than a few minutes: $0 with Medi-Cal, commonly $10 to $20 with a private-plan copay, about $75 if your deductible applies, and $20 on Medicare Advantage. For same-day evaluation, Express Care video visits for urgent care run Monday through Friday, noon to 8 pm, for MyChart account holders with a qualifying condition, billed as a standard video visit. UCSF publishes no separate note policy; the clinician who evaluates you decides.

Best for: Established UCSF patients who want the note in the same chart as the rest of their care.

Pricing: $0 to about $75 depending on coverage. Messages are reviewed on weekdays and can take up to three business days, so send early.

Limitations:

• Only providers you have seen in the last two years appear in the message list
• Three business days is too slow for a note due tomorrow; use Express Care or another option

When to choose something else: Non-UCSF patients should go to Kaiser if they are members, otherwise Sesame or their plan's vendor.

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4. Momentary — an ongoing California physician who documents visits as part of your care

Why it's included: Momentary connects California residents, San Franciscans included, with a licensed California physician they can message at any hour for a flat monthly fee; it is a primary care membership, not a note service. An AI assistant replies instantly and keeps the member's history, and the physician diagnoses, prescribes non-controlled medications and refills, orders labs, and refers to in-person care when needed, usually within minutes. Because the physician treating your flu is the one you messaged about blood pressure last month, documentation of a visit, when clinically appropriate, comes from someone who already knows you.

Best for: San Franciscans who want a personal physician for the everyday stuff, with documentation as a byproduct rather than the goal.

Pricing: $19.99 a month, HSA/FSA eligible, no per-visit fee, no insurance billing. A telehealth membership may be reimbursable from an SF MRA; check the eligible-expense list.

Limitations:

• You must live in California and use an iPhone
• If all you want is one note, a Sesame slot is cheaper than a month of membership
• The physician decides what to document; Momentary makes no promise of a note for any purpose
• Out of scope: emergencies, anything needing a hands-on exam, and controlled substances

When to choose something else: Sesame or your plan for one note and nothing else; Doctor On Demand or Amwell on Android or outside California.

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5. Teladoc, Amwell, Doctor On Demand, or MDLIVE — the vendor on your insurance card, or $79 to $99 cash

Why it's included: Most SF employer plans and Covered California plans bundle one of these four, often at a $0 copay, and San Francisco Health Plan Medi-Cal members get Teladoc at no cost 24/7 by registering at teladoc.com/sfhp or calling 1-800-835-2362 (not for members assigned to Kaiser or with Medicare Part B). All four are licensed in California and run around the clock. Without a plan: Amwell $79 (sick slips and back-to-work notes when appropriate, no FMLA or disability forms), MDLIVE about $82 to $85, Teladoc $89 (documentation at clinician discretion), and Doctor On Demand $99, which publishes a doctor's-note page and issues one only after a visit.

Best for: Anyone whose plan already includes one of these, and SFHP Medi-Cal members.

Pricing: $0 to your telehealth copay with insurance; $79 to $99 cash.

Limitations:

• Without a plan, you pay double or triple Sesame's price
• No continuity, and no FMLA, CFRA, or disability paperwork

When to choose something else: Sesame if you are paying cash; Momentary for an ongoing doctor.

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6. ZSFG Adult Urgent Care — the in-person fallback for uninsured and Healthy San Francisco residents

Why it's included: Zuckerberg San Francisco General's Adult Urgent Care at 1001 Potrero Ave, Building 5, Unit 1E, takes walk-ins 18 and up, and the treating clinician's visit paperwork documents your illness like any other clinic's. It belongs to the SF Health Network, so it bills Medi-Cal and serves Healthy San Francisco participants, who pay a quarterly program fee by income ($0 up to 100% of the federal poverty level, $60 at 101 to 200%, $150 at 201 to 300%, $300 at 301 to 400%, $450 at 401 to 500%) rather than a visit price. From July 1, 2026, hours are Monday through Friday 8 am to 6 pm and weekends and holidays 8 am to 4 pm; phone 628-206-8052.

Best for: SF residents without insurance, Healthy SF participants, and anyone whose symptoms need a hands-on exam anyway.

Pricing: Sliding scale for the uninsured; Medi-Cal billed; Healthy SF fee by income as above. Healthy SF enrollment happens in person with an application assistor, not at the urgent care window.

Limitations:

• In person only, and waits can be long
• Adults only

When to choose something else: Sesame or your plan's vendor for a mild illness. Anyone with chest pain, trouble breathing, stroke signs, or heavy bleeding belongs in the ER or on the phone with 911; the discharge summary then serves as documentation.

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7. DrSays — a dedicated note service with a real phone or video visit

Why it's included: DrSays does one thing: a licensed clinician speaks with you by phone or video and, if the account holds up, writes a note covering the days assessed. It serves California and posts its limits (five days per visit at most, ten days in any 30-day window, nothing antedated), and it books faster than most urgent cares.

Best for: Someone who would rather take a five-minute call than wait in a video queue.

Pricing: First visit $39.99; members pay $29.99 after that; cash only.

Limitations:

• Pricier than Sesame for the same result
• No primary care and no continuity

When to choose something else: Sesame for a cheaper live visit; Kaiser, UCSF, or Momentary for recurring absences.

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8. Trust Medical — a $34.99 form review, refunded if no note is issued

Why it's included: You fill in a written questionnaire, a California-licensed doctor reads it, and if the doctor agrees you receive a note carrying a QR code the employer can scan to verify; absences are capped at one to five days, nobody talks to you, and the fee comes back if no note results. It is last because a form is the thinnest evaluation on this list, though a licensed clinician still makes the call.

Best for: A short, uncomplicated absence when you cannot get on camera.

Pricing: $34.99 per request.

Limitations:

• Nothing live: no exam, prescription, insurance, or follow-up
• The refund policy does not bind your employer to accept the note

When to choose something else: Sesame, for almost everyone: similar price, live clinician.

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What San Francisco Employers and Schools Can Ask For

Treat this as guidance rather than legal advice, and confirm the policy that applies to you with HR, OLSE (415-554-6271), or your school.

• Paid sick leave, three or fewer consecutive workdays: a note requirement is deemed unreasonable under OLSE Rule 2.3, unless the leave was for an appointment (Rule 2.5) or there is a pattern or clear instance of abuse (Rule 2.4).
• Paid sick leave, more than three consecutive workdays: a note requirement is deemed reasonable. Full and partial days both count toward the run.
• What the note may say: only what is needed to show the leave was proper. OLSE's own example treats "unavailable for work for one week due to a medical operation" as sufficient, with no right to ask what the operation was (Rule 2.1), and the employer must keep the information confidential (Rule 2.2).
• Unpaid leave, PTO, and attendance points: after paid sick leave runs out, the handbook governs, and many SF employers require documentation.
• FMLA and CFRA: certification for a serious health condition is allowed, you get at least 15 calendar days to return it, and a same-day telehealth note is not the certification form.
• SFUSD: no doctor's note for an illness absence; verification may be requested after illness absences exceed 10% of school days. Colleges set their own rules.
• Gyms, airlines, events: the contract decides.
• Fake or altered notes: a misdemeanor under Penal Code 471.5, potentially forgery under Penal Code 470; employers call the number on the letterhead.

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Who Should Choose Each Option

• Called in sick for one or two days at an SF employer: you likely need nothing; cite OLSE Rule 2.3 if asked
• Need a note today and paying cash: Sesame Care, from about $34
• Kaiser member: Kaiser Get Care Now or an e-visit, $0 on most plans
• UCSF patient with a day or two of lead time: MyChart message or e-visit, $0 to about $75
• Want one ongoing California physician who documents visits as part of care: Momentary at $19.99 a month (California residents, iOS)
• Plan includes a telehealth vendor, or SF Health Plan Medi-Cal: Teladoc, Amwell, Doctor On Demand, or MDLIVE, $0 to copay
• Uninsured or on Healthy SF and need an exam: ZSFG Adult Urgent Care, sliding scale
• Prefer a quick phone call: DrSays, $39.99
• Cannot get on camera at all: Trust Medical, $34.99

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Frequently Asked Questions

Can my San Francisco employer require a doctor's note if I call in sick for one day? For paid sick leave under the SF Paid Sick Leave Ordinance, no: OLSE Rule 2.3 deems a note requirement for three or fewer consecutive workdays unreasonable. The exceptions are leave used for a medical appointment and a pattern or clear instance of abuse. Once paid sick leave is used up, or if the absence is unpaid, the employer's policy applies.

Does the three-day rule in San Francisco count partial days or a long weekend? The rule is written in consecutive workdays, full or partial, so two half days plus a full day count as three. Days you were not scheduled to work neither break nor extend the count. After the run passes three consecutive workdays, a note requirement is deemed reasonable.

Does SFUSD require a doctor's note when my child is out sick? No. As of the July 2026 handbook, an illness absence is excused when a parent or caregiver notifies the school through ParentVue, email, phone, or a signed note. An administrator may request medical verification only after illness absences or tardies exceed 10% of school days.

Can I use my SF MRA to pay for a telehealth visit that produces a note? Possibly. The SF MRA eligible-expense list includes telehealth and telemedicine consultations by live video, text message, or email, so a Sesame visit, a plan copay, or a Momentary membership may be reimbursable. Check the current list at sfcityoption.org before you file; accounts close after 36 months without a claim.

Can Momentary give me a doctor's note if I live in San Francisco? San Francisco is covered because Momentary serves all California residents, at $19.99 a month through its iOS app. The licensed California physicians can provide documentation of a visit when clinically appropriate as part of ongoing primary care; insurance is not billed, and there is no promise of a note for any purpose. For one note with no membership, Sesame is the cheaper buy.

How do I ask for a work note through UCSF MyChart, and will it cost anything? Open Messages, choose Ask a Question, then Message your Provider or Request eVisit, and describe the dates and reason. Most messages are free, but if the response needs clinical assessment or a completed form, UCSF may bill it as an e-visit: $0 with Medi-Cal, typically $10 to $20 with a copay, or about $75 if your deductible applies. Replies can take up to three business days.

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