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HARTFORD COUNTY PUBLIC SCHOOLS Fitness for Duty Certification Notice of Intent to Return to Work You are required to provide a fitness for duty certification and intent to return to work prior to
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How to fill out fitness for duty certification

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How to fill out fitness for duty certification

01
Contact your employer to request the fitness for duty certification form.
02
Fill out your personal information including name, employee ID, department, and supervisor's name.
03
Provide details about the reason for the certification such as injury, illness, or medical condition.
04
Consult with your healthcare provider to complete the medical evaluation section of the form.
05
Return the completed form to your employer within the specified deadline.

Who needs fitness for duty certification?

01
Employees who have been absent from work due to injury or illness and are seeking to return to work.
02
Employees who have a medical condition that may impact their ability to perform their job duties safely.
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Fitness for duty certification is a process where an individual's physical and mental ability to perform their job responsibilities is assessed by a healthcare provider.
Employees in certain high-risk or safety-sensitive positions may be required to file fitness for duty certification.
To fill out fitness for duty certification, employees need to schedule an evaluation with a qualified healthcare provider who will assess their ability to perform job responsibilities.
The purpose of fitness for duty certification is to ensure that employees are physically and mentally capable of safely performing their job responsibilities.
Fitness for duty certification may include information about the employee's medical history, current health status, and any restrictions or limitations on their ability to perform job responsibilities.
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