Get Intel Return To Work Activity Status Form

Filling out the Intel Return To Work Activity Status Form is an essential process for individuals returning to work after medical treatment. This guide provides clear, step-by-step instructions to help you navigate the online form efficiently.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. Begin by entering your name in the designated field. Ensure to provide your full name as it appears in official records.
3. Fill in your WWID, which is your unique identifier within the Intel system.
4. Provide your contact number in the EE Contact # field. This should be a current and reachable number.
5. Specify your shift by entering the start and end times. Include information on which shift you work at Intel.
6. List your Fab location where applicable.
7. Enter your manager's name in the appropriate section.
8. Indicate the reason for your visit to Health Services. Be concise but clear in your description.
9. Mention who authorized your appointment in the 'Appointment authorized by' field, choosing between Occupational Health Nurse (OHN) or Medical Case Manager (MCM).
10. Complete the section designated for health care providers, which includes the date of your injury and the date of initial treatment.
11. Fill in the name of the health care provider you visited and provide a brief description of your condition or diagnosis.
12. List all treatments, therapies, medications, and dosages prescribed for your condition in detail.
13. Answer whether you believe your injury or illness is work-related by checking the appropriate box for ‘yes’ or ‘no.’
14. Complete one of the four statements regarding your return to work status, specifying if you return with or without restrictions and providing the effective date where required.
15. Once all fields are filled, review your entries for accuracy. Ensure that all information is complete and correct.
16. Save your changes, and choose to download, print, or share the completed form as needed.

Complete your Intel Return To Work Activity Status Form online today for a smooth transition back to work.