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RETURNTOWORK RELEASE Date ___ Employee Name ___ Address ___ City, State, Zip ___ Please complete the following information and fax it to Northwest Youth Corps, 5413495060. 1) Is the worker medically

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How to fill out return-to-work release

01

Schedule a visit with your healthcare provider

02

Discuss your readiness to return to work with your healthcare provider

03

Request a return-to-work release form

04

Fill out the form accurately with your personal details and any restrictions or accommodations needed

05

Return the completed form to your employer

Who needs return-to-work release?

01

Employees who have been on medical leave

02

Employees who have had a work-related injury

03

Employees who have been diagnosed with a medical condition that may affect their ability to work

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What is return-to-work release?

Return-to-work release is a medical document that authorizes an individual to return to work after being on leave due to a medical condition.

Who is required to file return-to-work release?

Employees who have been on medical leave and wish to return to work are required to file a return-to-work release.

How to fill out return-to-work release?

Return-to-work release can be filled out by the employee's healthcare provider and may require information about the medical condition, treatment plan, and any work restrictions.

What is the purpose of return-to-work release?

The purpose of return-to-work release is to ensure that employees are medically cleared to return to work and to provide information to the employer about any necessary accommodations or restrictions.

What information must be reported on return-to-work release?

Return-to-work release must include details about the individual's medical condition, treatment plan, any work restrictions, and the healthcare provider's contact information.

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