Follow the steps to complete the form correctly.

1. Click the ‘Get Form’ button to download the Return To Work form and open it in an editing tool of your choice.
2. Fill in your name in the format of Last, First, Middle Initial. Ensure that you print clearly to avoid any misunderstandings.
3. Enter your Employee ID Number in the specified field. This is important for identifying your records.
4. Provide your Last Day Worked to help document your leave history.
5. Specify your Actual Return to Work Date, which should align with the day you are returning.
6. Indicate whether your return is related to a Worker’s Compensation claim by marking Yes or No.
7. List any physical or reduced schedule restrictions provided by your doctor as you prepare to return to work.
8. Enter the School/Department where you are employed.
9. Detail your Current Job title to clarify your role.
10. Fill in your Supervisor’s Name to ensure appropriate oversight.
11. Sign and date the form to certify that all information provided is true and accurate. Remember to attach the documentation from your health care provider.
12. If you have restrictions, ensure you have contacted both your Supervisor and Human Resources prior to returning to work.
13. For Human Resources, leave the section for their review of work restrictions blank as they will complete this after your submission.
14. Once all fields are completed, save any changes, download for your records, and print or share the form as needed.

Complete your Return To Work Form online to ensure a smooth transition back to work.