We typically use the physical capacities form but in some instances we may also require cognitive clearance for RTW.

Lisa Dyrdahl, RN, BSN

Employee Health Nurse

Valley Medical Center

Ph: 425-228-3440 ext. 5720

Fax: 425-656-5066

From: MCOH-EH [mailto:mcoh-eh-bounces+lisa_dyrdahl=valleymed.org@mylist.net] On Behalf Of Enass
Sent: Sunday, August 24, 2014 12:04 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Return to Work Form

Thanks for the questions . The form we are looking for is a general one for employees who have been off work for a prolonged time so more of a fitness for duty one.

Sent from my iPhone

On Aug 24, 2014, at 6:48 PM, "Thrasher, Terri" <Terri.Thrasher@cchmc.org> wrote:

Can you identify the goal of your RTW form. Is this after employee injury or infectious illness or fitness for duty or ADA? Or personal illness?

Thank you for your email.

Kindest regards,

Terri

Terri L. Thrasher RN MSN
Sr. Director HR Professional Services
Cincinnati Children’s Hospital Medical Center
3333 Burnet Ave MLC 9006
Cincinnati, Ohio 45229
513-636-6240 office
513-236-1202 cell
513-736-4305 pager

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Enass Awad
Sent: Sunday, August 24, 2014 9:15 AM
To: MCOH/EH
Subject: [MCOH-EH] Return to Work Form

Dear Colleagues:
Will be very obliged if you can share drafts or templates of return to work forms that you use. We are developing a new form for the university employees and I will like to look at multiple formats before finalizing our own. This is a major science research university however employees' backgrounds range from teaching academic staff to adminsitrative staff to postdoc and postgraduate students.

Thanks in advance,

Enass.

--
Enass Awad A/Rahman,MD,MPH,FACOEM
Occupational Medicine Consultant
King Abdullah University of Science and Technology
Thuwal-Jeddah
Kingdom of Saudi Arabia
Tel: 0966128084102
Mobile :0966548543844
Email: enass.arahman@kaust.edu.sa

"We can enrich the world if we choose to embrace our similarities; we can destroy the world if we choose to emphasize our differences."

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