Scribd Logo
Upload

Welcome to Scribd!

  • OHS-FRM-001 Return To Work Validation Slip Clinic

    Uploaded by

    PITX Medic
    18 views1 page
    This form is used to validate a patient's return to work after an absence. It collects information about the patient, their supervisor, dates of absence, and the disposition determined by medical personnel such as returning to work, working with accommodation, or being unfit for work. The clinic personnel sign off on the validation.

    Original Description:

    Original Title

    OHS-FRM-001 Return to Work Validation Slip Clinic copy

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This form is used to validate a patient's return to work after an absence. It collects information about the patient, their supervisor, dates of absence, and the disposition determined by medical personnel such as returning to work, working with accommodation, or being unfit for work. The clinic personnel sign off on the validation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    18 views1 page

    OHS-FRM-001 Return To Work Validation Slip Clinic

    Uploaded by

    PITX Medic
    This form is used to validate a patient's return to work after an absence. It collects information about the patient, their supervisor, dates of absence, and the disposition determined by medical personnel such as returning to work, working with accommodation, or being unfit for work. The clinic personnel sign off on the validation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    HHC-OHS-FRM-001

    VERSION NO: 0
    Return to Work Validation Slip DOCUMENT: Forms

    Page 1 of 1

    Patient: Date:
    EE#: Time in: Time out:
    Supervisor: Department:
    Medical Clinic Issuer/Date Issued: Inclusive Dates of Absence:
    DISPOSITION: Medical Certificate Validation
    Return to work Valid Medical Certificate
    Fit to work with accommodation Invalid Medical Certificate
    Unfit to work/sent home For Call-out Verification

    REMARKS:

    Clinic Personnel:

    HHC-OHS-FRM-001
    VERSION NO: 0
    Return to Work Validation Slip DOCUMENT: Forms

    Page 1 of 1

    Patient: Date:
    EE#: Time in: Time out:
    Supervisor: Department:
    Medical Clinic Issuer/Date Issued: Inclusive Dates of Absence:
    DISPOSITION: Medical Certificate Validation
    Return to work Valid Medical Certificate
    Fit to work with accommodation Invalid Medical Certificate
    Unfit to work/sent home For Call-out Verification

    REMARKS:

    Clinic Personnel:

    You might also like