APPENDIX C - MEDICAL CERTIFICATE Sample Clauses

APPENDIX C - MEDICAL CERTIFICATE. PART 1 I, hereby authorize my Health Care Professional(s) to disclose medical information to my employer,. In order to determine my ability to fulfill my duties as a from a medical standpoint, and whether my medical situation is such that it can support my sustained return to work in the foreseeable future. To this end, I specifically authorize my Health Care Professional(s) to respond to those questions from my employer set out in the medical certificate dated dd mm yyyy for my absence starting on the dd mm yyyy Signature Date Employee ID: Dear Health Care Professional, please be advised that the Employer has an accommodation and return to work program. The parties acknowledge that the employer has an obligation to provide reasonable accommodation to the point of undue hardship, and that the employee has an obligation to cooperate with reasonable accommodation measures. Consistent with this understanding, and with the objective of returning employees to active employment as soon as possible, we would ask the medical professional to provide as full and detailed information as possible. Please return the completed form to the attention of: Telephone No: Employee Address: Work Location:
Sample 1
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APPENDIX C - MEDICAL CERTIFICATE. PART 1 I, hereby authorize my Health Care Professional(s) to disclose medical information to my employer,. In order to determine my ability to fulfill my duties as a from a medical standpoint, and whether my medical situation is such that it can support my sustained return to work in the foreseeable future. To this end, I specifically authorize my Health Care Professional(s) to respond to those questions from my employer set out in the medical certificate dated dd mm yyyy for my absence starting on the dd mm yyyy Signature Date Dear Health Care Professional, please be advised that the Employer has an accommodation and return to work program. The parties acknowledge that the employer has an obligation to provide reasonable accommodation to the point of undue hardship, and that the employee has an obligation to cooperate with reasonable accommodation measures. Consistent with this understanding, and with the objective of returning employees to active employment as soon as possible, we would ask the medical professional to provide as full and detailed information as possible. Please return the completed form to the attention of: Employee ID: Telephone No: Employee Address: Work Location:
Sample 1

Related to APPENDIX C - MEDICAL CERTIFICATE

  • Medical Certificate  Absent from Work (first date of absence)  Not absent from work but requires accommodations Part 1 – Employee - please complete following: (Employee Name) The information supplied will be used in a confidential manner and may assist in creating a return to work plan. I hereby consent to the completion of this form by: (Treating Medical Practitioner’s Name) (Signature of Employee) (Date)

  • Medical Certification (1) The University may require an employee to provide medical certification from a health care provider for FMLA leave without pay when taken for the serious health condition of the employee or the employee's family member.

  • Medical Certificates (a) An employee who has given the Employer notice of their intention to take paid or unpaid parental leave, or unpaid partner leave shall provide the Employer with a medical certificate from a registered medical practitioner naming the employee, or the employee’s partner, confirming the pregnancy and estimated date of birth.

  • National Certification Any teacher covered by this agreement who is certified by the National Board for Professional Teaching Standards shall be reimbursed up to $2,000 for the costs upon completion of the program. No more than two

  • Physician's Certificate When a female employee applies for pregnancy leave she must provide her supervisor with a certificate from her physician stating that she is pregnant and giving the estimated date of delivery at least two weeks prior to the date she plans to commence the leave. In the case of a female employee who stops working prior to the commencement of her scheduled leave because of a birth, still-birth or miscarriage that happens earlier than the employee was expected to give birth, that employee must, within two weeks of stopping work, give her supervisor:

  • Final Certificate, Design Professional’s Certificate of Final Completion The Certificate issued by the Design Professional stating that all work has been completed in accordance with the terms of the Contract Documents. See Section 6,

  • Provisional Certificate 14.3.1 The Independent Engineer may, at the request of the Concessionaire, issue a provisional certificate of completion substantially in the form set forth in Schedule-J (the "Provisional Certificate") if the Tests are successful and the Bus Terminal can be safely and reliably placed in commercial operation though certain works or things forming part thereof are outstanding and not yet complete. In such an event, the Provisional Certificate shall have appended thereto a list of outstanding items signed jointly by the Independent Engineer and the Concessionaire (the "Punch List"); provided that the Independent Engineer shall not withhold the Provisional Certificate for reason of any work remaining incomplete if the delay in completion thereof is attributable to the Authority.

  • Instructions for Certification – First Tier Participants a. By signing and submitting this proposal, the prospective first tier participant is providing the certification set out below.

  • Institutional Certification Certification by the Submitting Institution that delineates, among other items, the appropriate research uses of the data and the uses that are specifically excluded by the relevant informed consent documents. Further information may be found here.

  • SICK LEAVE / Medical Certificates and Reporting 10.1 Sick leave with pay shall be granted to a teacher on account of injury to or the illness or disability of the teacher, or for the purpose of obtaining necessary medical or dental treatment.

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