Workers' Comp Return to Work Form - ok 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the employee’s name, appointment date, Social Security Number (SSN), date of injury, and employer's name in the designated fields.
3. Provide a brief diagnosis of the injury or illness in the appropriate section.
4. Select the appropriate return to work status by checking one of the options provided. Ensure you understand each option before making your selection.
5. If applicable, complete the restrictions section by checking all that apply and providing detailed descriptions for temporary and permanent restrictions.
6. Fill in any additional notes regarding follow-up treatment, medications, and physician’s notes as required.
7. Finally, ensure that the physician signs and dates the form before submitting it back to the employer.

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