Get Canada Csss De Laval Assignation Temporaire Dun Travailleur 2011-2025

Filling out the Canada CSSS De Laval Assignation Temporaire Dun Travailleur form is an important step in facilitating the temporary assignment of a worker affected by a professional injury. This guide provides clear instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by entering the worker's identification details in the following fields: 'NOM' (last name), 'PRÉNOM' (first name), 'N.A.S.' (social insurance number), and 'N.A.M.' (medical insurance number). Ensure that all information is accurate.
3. Indicate whether the worker can perform their regular job by selecting 'Oui' (Yes) or 'Non' (No). If 'Non', then proceed to inquire about the possibility of a temporary assignment and select 'Oui' (Yes) or 'Non' (No) accordingly.
4. Fill in the dates for the start and end of the assignment using the provided date fields: fill in the year, month, and day.
5. Complete the proposed assignment identification section with relevant details about the proposed work that respects any functional limitations. Provide an appropriate description.
6. In the functional limitations section, check the applicable positions permitted (Assise, Debout, Alternée debout/assise, Penchée) and any movements to be discouraged, such as lifting or pushing.
7. Specify the maximum weight limitations that the worker can handle based on their condition.
8. Note any additional restrictions (for example, related to stairs or arm heights) that need to be acknowledged.
9. The treating physician must sign the document and complete the section responding to whether the worker can reasonably perform the work, confirm safety, and support rehabilitation.
10. The physician should include their signature, date, and ensure all parts of the form are filled out before final submission.
11. After completing the form, save the changes, and then download or print it. The completed form can be shared or sent as needed.

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