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How to use or fill out Return To Work Template Form - Fill Online, Printable, Fillable with DocHub
- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the Employee Section. Enter your name and CWID in the designated fields.
- Provide the Date of Injury/Illness by selecting the appropriate day, month, and year.
- In the Physician Section, indicate whether you may resume work at full duty or with restrictions. Fill in the effective date accordingly.
- If there are restrictions, specify them along with the expected duration of accommodations. Choose between Full Time or Part-Time and indicate hours per day or week.
- Select the type of work capacity (Sedentary, Light, Medium, Heavy) that applies to you and provide any additional details if necessary.
- Complete the physician's information including name, signature, date, phone number, and address before submitting it to Human Resources.
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