Work release form - The University of Texas at San Antonio 2026

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The document is a Return to Work Release Form from The University of Texas at San Antonio, which must be submitted to the HR Leave department before an employee can return to work after a medical leave. It includes sections for employee information, physician's statements regarding work restrictions, and guidelines for minimizing the release of medical information. The form also emphasizes compliance with the Genetic Information Nondiscrimination Act (GINA) by prohibiting the inclusion of genetic information.

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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, and middle initial. Specify your normal work week, shift times, department, title, and hours per day.
In the PHYSICIAN'S STATEMENT section, ensure that your physician completes the required fields regarding maximum hours per day and lifting capacity. They should also indicate any physical restrictions related to your job.
Review the return to work conditions specified by your physician. Make sure they sign and date the form before submission.
Once all sections are completed accurately, save your changes and submit the form to HR Leave Administration as instructed.

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