Return work medical certification 2026

1. Click ‘Get Form’ to open the return work medical certification in the editor.
2. In Part 1, enter your full name, including first name, middle initial, and last name. Then, specify the date your leave began.
3. Next, provide your job title or position in the designated field.
4. Sign and date the form at the bottom of Part 1 to confirm that all information is accurate.
5. Move to Part 2 for your healthcare provider to complete. They should enter the date of certification and their name.
6. Your healthcare provider must sign and date this section to validate that you are fit to resume work with or without accommodations.

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