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Return to work form

Return work release 2026

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The document is a Return to Work Release Form for employees at The University of Texas at Austin, which must be completed by both the employee and their healthcare provider. It outlines the process for returning to work after a medical leave, including any restrictions related to the employee's condition. The form ensures that necessary information is communicated to supervisors while minimizing the release of sensitive medical details. It also includes compliance with ADAAA and GINA regulations.

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Click ‘Get Form’ to open the return work release in the editor.
Begin by entering your personal information in the designated fields: Name, UT EID, Shift, Department, Work Phone, and Home Phone.
Provide your Supervisor's name and ensure you read the acknowledgment regarding workplace restrictions. This is crucial for a smooth transition back to work.
Sign and date the form at the bottom of the employee section to confirm your understanding of the conditions outlined.
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.
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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