Get Functional Assessment Form (faf)

Filling out the Functional Assessment Form (FAF) online is an essential step to support employees in their recovery from illness or injury. This guide will take you through each component of the FAF, ensuring you complete the form accurately and efficiently.

Follow the steps to fill out the Functional Assessment Form (FAF) online.

1. Press the ‘Get Form’ button to access the form and open it in your editor.
2. Complete Section A: This section requires you to fill in personal details. Provide your full name, employee number, position, date of birth, employee phone numbers, program/department, work site, the first full day of absence, manager’s name, and their phone number.
3. Review the authorization statement: Confirm your understanding that you authorize the physician to release the requested information to Eastern Health by ensuring your signature is provided.
4. Move to Section B: This section is to be completed by the attending physician. As the employee, you will not fill this part out; it is essential your physician completes it during the first five days of absence.
5. Instruct your physician to identify the primary and secondary diagnosis, including surgery details if applicable, and any referrals to other healthcare providers.
6. In Section C, the physician will assess functional limitations. Although you cannot fill this out, you should be aware of the types of limitations assessed, including cognition, mobility restrictions, and the classification of work fitness.
7. Once all sections are completed, ensure your form is signed where necessary. Save the changes to the form in your editor.
8. Download, print, or share the completed form as needed, ensuring it is returned to Occupational Health within 14 calendar days of your absence.

Complete your Functional Assessment Form (FAF) online today to assist in your recovery process.