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Return to work release form - UTSA 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the EMPLOYEE INFORMATION section. Enter your last name, first name, middle initial, and employee ID. Specify your normal work week, shift times, division, department, title/position, and hours per day.
- Next, ensure that the PHYSICIAN'S STATEMENT is completed by your treating doctor. They will indicate whether you can return to work with or without restrictions and provide relevant dates.
- If there are any restrictions on your return to work, have your physician detail them in the designated area. This includes maximum hours per day and physical capabilities such as lifting or carrying weight.
- Finally, ensure that your physician signs and dates the form before submission. This signature is required for processing.
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