Get Walmart Return To Work Certification Form

This guide provides a step-by-step approach to completing the Walmart Return To Work Certification Form online. The form is essential for associates returning from medical leave, ensuring a smooth transition back to work.

Follow the steps to complete the Walmart Return To Work Certification Form online.

1. Press the ‘Get Form’ button to access the form and open it in the editor.
2. In Section A, provide your personal information, including your name, WIN, facility number, and contact details. Ensure all fields are accurately filled out.
3. If applicable, indicate your expected return to work date and any preferred method of contact.
4. In Section B, have your health care provider complete the medical release information, certifying your ability to return to work by entering the appropriate dates and conditions.
5. If there are restrictions on your return, ensure your health care provider details these carefully, including specifics on activities and duration.
6. Once Section B is filled out by your health care provider, review it to ensure completeness and clarity.
7. In Section C, if you are a supervisor or HR representative, complete the return-to-work status and sign to indicate review. Check the appropriate box for return status and include the date.
8. After all sections are completed, save your changes. You can download, print, or share the form as necessary.

To complete your Walmart Return To Work Certification Form online, follow the above steps diligently.