Employee’s Request for Light Duty Work Form, 8.5 x 11, 75 Pack, J. J. Keller & Associates, Inc.

Employee’s Request for Light Duty Work Form, 8.5 x 11, 75 Pack, J. J. Keller & Associates, Inc.

• LIGHT DUTY: Request for light work form should be completed by a healthcare provider along with employee requesting light duty due to an injury. Request would be needed in the case of limitations keeping employee from completing regular duties.
• DESIGN: HR form is designed with plenty of space and appropriate fields for healthcare provider to provide necessary information explaining employee’s limitations. Once completed by employee and provider a supervisor can add notes along with approval.
• QUALITY: Form is printed on quality bond paper. English only. Made in the USA.
• SIZE: Measures 8 1/2” x 11”. Pack of 75 sheets.