Alameda status report 2026

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 for the present medical problem and specify if the employee is unable to work full duty or has been released to modified/full duty.
4. Provide a diagnosis or general nature of illness/injury, ensuring patient permission is noted.
5. Detail any specific medical restrictions across various categories such as vehicle use, body positions, environmental factors, and lifting/carrying limitations.
6. Estimate the return to full duty date and indicate whether restrictions are permanent.
7. Complete any additional questions regarding treatment requiring time off or medication effects on work capabilities.
8. Finally, have the treating physician or clinician sign and date the form before saving it for distribution.

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