Return work release 2026

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  1. Click ‘Get Form’ to open the return work release in the editor.
  2. Begin by entering your personal information in the designated fields: Name, UT EID, Shift, Department, Work Phone, and Home Phone.
  3. Provide your Supervisor's name and ensure you read the acknowledgment regarding workplace restrictions. This is crucial for a smooth transition back to work.
  4. Sign and date the form at the bottom of the employee section to confirm your understanding of the conditions outlined.
  5. Next, have your healthcare provider complete their section. They will indicate whether your condition is work-related and specify any restrictions or capabilities regarding your return to work.
  6. Ensure that all necessary signatures are obtained from both you and your healthcare provider before submitting the form to your supervisor.

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Versions Form popularity Fillable & printable
2016 4.8 Satisfied (245 Votes)
2015 4.4 Satisfied (392 Votes)
2012 4.3 Satisfied (76 Votes)
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