Get Modified Duty Bformb - Hsc - Winnipeg Regional Health Authority

Filling out the Modified Duty BFormb is an essential step in facilitating a safe return to work. This guide provides clear instructions on how to complete the form online, ensuring that you include all necessary information to meet the requirements of the Winnipeg Regional Health Authority.

Follow the steps to successfully complete your Modified Duty BFormb.

1. Click the ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering the employee information. Fill in the name, position, and site where the employee works. Be sure to provide details regarding any restrictions on physical demands, exertion capabilities, or psychosocial demands.
3. In the WORK ABILITIES section, indicate all relevant restrictions. Check the corresponding boxes for physical demands, such as lifting, bending, and standing to accurately represent the employee's capabilities.
4. Provide healthcare provider information, including their name and contact details. The provider must indicate whether there are any restrictions and specify the levels of exertion capabilities as required.
5. Complete the sections related to examination information and comments regarding the employee's psychosocial demands. This should include the nature of any illness or injury while ensuring confidentiality.
6. Specify the details regarding the return to work, including whether it is temporary or permanent and with what modified duties and hours. Clearly indicate the estimated duration of the modifications.
7. Ensure that both the employee and healthcare provider sign the form where indicated. This approval is necessary for the release of the information to the Winnipeg Regional Health Authority.
8. Once all sections are completed, review the form for accuracy. You can then save changes, download, print, or share the completed form as needed.

Complete your Modified Duty BFormb online today for a smooth and efficient return to work.