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Here's my advice.
I would file a report with your state association and include a copy but keep the original and file it for safe keeping. Keept it until the statute of limitations runs.
Do not staple it in the score book, dont let anyone else have it.
If there is litigation it is the one thing that may save you. Accepting the note places the MD in in the position of liability. You will have to show reasonable reliance on appropriate medical advice. However if it is not reasonable or appears to be bogus you can and should question it. When officiating football we have ahad notes come out of the stands and we always ask the basic questions so we know the guy is a MD and that he understands the liability is now on him.
It cant be anything less than a physician... No PA's. no nurses, no Physical therapists, etc
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