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Get Work Restrictions Form 2008-2024

Tions Yes Posture/Movement No Estimated duration of the restrictions? _________________________________ Please indicate in hours/minutes Example Sit for 2 Hrs at a time for a total of 8 Hr with a 15 mi break of sitting ____standing x walking x Sit for _______at a time for a total of ________ with a ________ break of sitting ____standing ____walking ____ Stand for ________ at a time for a total of ______ with a ________ break of sitting ____standing ____walking ____ Walk for ________ at a ti.

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