Return to work program sample 2026

1. Click ‘Get Form’ to open the return to work program sample in the editor.
2. Begin by filling out the employee's personal information, including their name and social security number, in the designated fields.
3. Complete the Work Capabilities Form by having the physician provide details about the employee's diagnosis, restrictions, and capabilities. Ensure all sections are filled accurately.
4. For temporary modified or alternate work assignments, specify the temporary department assigned and supervisor’s name. Document any restrictions as indicated by the physician.
5. Utilize the Supervisor’s Responsibilities section to outline your commitment to safety and communication with both management and employees regarding their recovery process.
6. Review all entries for accuracy before saving or sharing the completed form. Use our platform’s features to sign and distribute as needed.

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