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  • Walmart Return To Work Certification Form

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Return to Work Certification (Medical Leave) ASSOCIATE: COMPLETE SECTION A HEALTH CARE PROVIDER: COMPLETE SECTION B MANAGER/SUPERVISOR OR HR REPRESENTATIVE: COMPLETE SECTION C Dear Associate: If you.

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- You must confirm that you have returned to work on your first day back by calling the UCI Leave Service Center at 855-922-2152 or by accessing the Sedgwick Online Portal at hr.uci.edu/sedgwick.

To report your return to work, visit mySedgwick via One.Walmart.com/LOA OR call Sedgwick's automated IVR line at 1.800. 492.5678 - Option 3. Return to work certification bring your completed certification form on your first day back to work or submit a copy to Sedgwick prior to returning.

If unable to provide a job adjustment, contact Sedgwick at 855-489-1600 to discuss next steps.

If you need to extend your leave of absence, notify Sedgwick before the end of your current leave to request an extension. 3. Provide additional documentation, as requested, within 20 days. Failure to do so may result in delay or denial of your leave or leave extension.

a. To report your return to work, visit mySedgwick via One.Walmart.com/LOA OR call Sedgwick's automated IVR line at 1.800. 492.5678 - Option 3. Return to work certification bring your completed certification form on your first day back to work or submit a copy to Sedgwick prior to returning.

Contact Sedgwick Request a leave online at mySedgwick.com or by phone at 800-492-5678.

If you qualify for paid leave benefits, Sedgwick will coordinate your pay. Your payments will be processed through Walmart Payroll and you'll be paid on regular paydays. When your leave is complete, you're required to report your return to work to Sedgwick.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232