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Return to work release form - UTSA

Return to work release form - UTSA 2025

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The document is a Return to Work Release Form that must be completed by an employee's treating doctor and submitted to the HR Leave department before the employee can return to work. It includes sections for employee information, physician's statement regarding work status, and any restrictions on the employee's ability to perform their job. The form aims to minimize the release of medical information while ensuring compliance with workplace accommodations and legal regulations such as GINA.

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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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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (76 Votes)
2017	4.2 Satisfied (50 Votes)

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How to complete a return to work form?

Attach any existing doctors assessment to the return to work form. Discuss any reasonable adjustments if they are still recovering, but fit to work, or if they suffer with long term effects. You need to know if any medication will affect their performance or maybe their ability to drive into work.

What is the return to work form?

A return to work form is a document employers use to record relevant details when staff start working again after sickness. You should fill it in during the return to work interview, to establish further necessary steps. Some employees need support with a long recovery, for example.

What is the purpose of a release form?

A release form, or general release form, is a legal document that serves as consent in writing to release the legal liability of a releasee by a releasor. The document is a formal acknowledgment that, once signed, is a legal release of all a releasee obligations within an agreement.

What is a return to work release form?

A Return to Work Release Form is a document that outlines important information about an employees ability to return to work after a medical leave, injury, or other health-related issues.

What is the purpose of a return to work?

As the name suggests, a return to work interview is a meeting held with an employee after a period of absence. The primary purpose of a return to work interview is to welcome the employee back, discuss the reasons for their absence and confirm that they are fit to attend work.

What is a release to return to work?

A physician release to return to work form is a document that verifies an employees fitness to resume work after a period of illness or injury. It serves as evidence that the employee is healthy enough to perform their job duties.

Return to work release form - UTSA 2025

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