Alameda status report 2025

1. Click ‘Get Form’ to open the Alameda Status Report in the editor.
2. Begin by entering the employee's name, department name/number, job title, and claim number/date of injury in the designated fields.
3. Indicate the examination dates and whether the employee is unable to work full duty. If applicable, check the appropriate boxes for modified or full duty release.
4. Provide a diagnosis or general nature of illness/injury, ensuring patient permission is noted.
5. Detail any specific medical restrictions in the provided sections, including vehicle use, body positions, environmental factors, and lifting/carrying restrictions.
6. Complete the estimated return to full duty date and indicate if restrictions are permanent.
7. Finally, provide information regarding any treatment requiring time off or medication that may affect work capabilities.
8. Sign and date the form at the bottom before submitting it as required.

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