The Connecticut Employee Medical & Work Status Form is a document used by employers in the state of Connecticut to collect information on the health status and work situation of their employees. This form is typically used to document the medical status of an employee in order to prevent the spread of contagious diseases in the workplace. It is also used to document an employee’s work status for the purpose of scheduling, time-off, or workplace safety. The form is provided by the Connecticut Department of Labor. The Connecticut Employee Medical & Work Status Form includes a variety of sections, such as the employee’s name, date of birth, address, phone number, and other contact information. It also requests information regarding the employee’s health status, including any medical conditions that may affect their ability to work. The form also includes a section to document an employee’s work status, such as whether they are currently employed, on leave, or have been laid off. There are two types of Connecticut Employee Medical & Work Status Forms: the Standard Form and the Special Form. The Standard Form is used for regular employees and the Special Form is used for employees with special medical needs or disabilities.