Get the free Return to Work Form - Human Resources - Lakehead University

Lake head University: Employee Medical/Work Limitation Form Human Resources Department 955 Oliver Road Thunder Bay, Ontario P7B 5E1 343-8334 or FAX 346-7701 For Employees with Non-Occupational Injuries

How to fill out return to work form

How to fill out return to work form:

1. Begin by providing your personal information, such as your full name, employee ID, and contact details. This will help the employer identify you and reach out if needed.
2. Indicate the date on which you are planning to return to work. Make sure to be accurate and clear so that the employer can plan accordingly.
3. Specify if you have any accommodations or special requirements that need to be taken into consideration upon your return. This could include adjustments to your workstation, flexible work hours, or other accommodations that may be necessary due to a medical condition or injury.
4. If applicable, describe any restrictions or limitations regarding your ability to perform certain tasks. This information is important for your employer to ensure your safety and well-being at the workplace.
5. If you have been on leave due to a medical condition or injury, provide details regarding your diagnosis, treatment, and any medical professional involved in your care. This information may assist your employer in understanding the nature of your absence and any necessary precautions to be taken upon your return.
6. Sign and date the form to validate its completion. It is essential to provide this signature as it signifies your acknowledgment and agreement to the information provided.

Who needs return to work form:

1. Employees who have been on leave due to a medical condition or injury and are planning to return to work.
2. Individuals who require accommodations or adjustments in their workplace due to a medical condition or injury.
3. Employers who need to ensure the safety, well-being, and smooth transition of their employees returning to work after a leave of absence.

For pdfFiller’s FAQs

What is return to work form?

Return to work form is a document that an employee must complete after being on leave or sick leave to confirm their return to work.

Who is required to file return to work form?

Any employee who has been on leave or sick leave and is returning to work is required to file a return to work form.

How to fill out return to work form?

The employee must fill out their personal information, the dates of their leave, any relevant medical information, and sign the form to confirm their return to work.

What is the purpose of return to work form?

The purpose of the return to work form is to ensure that the employer is aware of the employee's return to work, as well as any medical restrictions or accommodations that may be necessary.

What information must be reported on return to work form?

The return to work form must include the employee's personal information, the dates of their leave, any relevant medical information, and any restrictions or accommodations needed for their return.

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