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Sedgwick Claims Management Services, Inc 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the Employee section. Enter your name, claim number, employee ID, and the dates for when your leave began and your expected return to work.
- Sign and date the form in the designated areas to confirm your understanding that you cannot return without a release from your health care provider.
- Next, provide this form to your Health Care Provider. They will need to complete their section by certifying your ability to return to work and indicating any restrictions or accommodations necessary.
- Ensure that the Health Care Provider fills in their signature, date, and contact information before submitting the completed form.
- Finally, fax a copy of the completed form to Sedgwick at 1-866-856-4862 as required by your supervisor.
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| Versions | Form popularity | Fillable & printable |
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| 2024 | 4.7 Satisfied (50 Votes) | |
| 2024 | 4.1 Satisfied (26 Votes) | |
| 2022 | 4.9 Satisfied (41 Votes) | |
| 2022 | 4.8 Satisfied (52 Votes) | |
| 2022 | 4.7 Satisfied (37 Votes) | |
| 2022 | 4.1 Satisfied (56 Votes) | |
| 2022 | 4.5 Satisfied (39 Votes) | |
| 2022 | 1.2 Satisfied (406 Votes) | |
| 2021 | 4.5 Satisfied (50 Votes) | |
| 2021 | 4.8 Satisfied (114 Votes) | |
| 2021 | 4.3 Satisfied (37 Votes) | |
| 2020 | 4.8 Satisfied (53 Votes) | |
| 2020 | 4.8 Satisfied (121 Votes) | |
| 2020 | 4.8 Satisfied (137 Votes) | |
| 2020 | 4.6 Satisfied (59 Votes) |
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Related links
Sedgwick Claims Management Services, Inc./Southwest Medical Provider Network. Address 8125 Sedgwick Way Memphis, Tennessee 38125-1128 Telephone : (210) 332-1608
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