Medical consent form to return to work 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's name and contact information in the designated fields. This ensures that all communications are directed appropriately.
3. Next, input the health care provider's name and title, along with their contact details. This is crucial for verification and follow-up.
4. In section 1, indicate the dates during which the patient is unable to work. Be precise to avoid any confusion regarding their leave period.
5. For Workers’ Compensation Leaves, complete section 2 if applicable. Specify if the patient can return to alternate duty and provide necessary details.
6. Sections 4 and 5 require you to assess the patient's physical capabilities. Check appropriate boxes for activities like sitting, standing, lifting, and more based on your evaluation.
7. Finally, ensure that both the health care provider and patient sign where indicated. This authorizes the release of medical information as needed.

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