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Medical Department Return to Work Information Sheet
A return-to-work evaluation is an individualized assessment of your fitness-for- duty (your ability to return to work and safely perform your essential job
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Family Medical Leave Act (FMLA) fitness for duty certification
You must return this completed Fitness for Duty. Certification form to Human Resources as requested, or your return to work may be delayed or denied under the
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FITNESS FOR DUTY CERTIFICATION
FACULTY/STAFF: You are being requested to provide a completed fitness for duty certification prior to returning to work from your extended medical absence.
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