Common use of Care Professional to complete Clause in Contracts

Care Professional to complete. From the date of this assessment, the above will apply for approximately: 6-10 days 11- 15 days 16- 25 days 26 + days Have you discussed return to work with your patient? Yes No Recommendations for work hours and start date (if applicable): Regular full time hours Modified hours Graduated hours Start Date: dd mm yyyy Is patient on an active treatment plan?: Yes No Has a referral to another Health Care Professional been made? Yes (optional - please specify): If a referral has been made, will you continue to be the patient’s primary Health Care Provider? No Yes No 4: Recommended date of next appointment to review Abilities and/or Restrictions: dd mm yyyy Completing Health Care Professional Name: (Please Print) Date: Telephone Number: Fax Number: Signature: LETTER OF AGREEMENT #1 BETWEEN The Council of Trustees’ Associations/ Le Conseil des associations d’employeurs (hereinafter called ‘CTA/CAE’) AND The Ontario Secondary School Teachers’ Federation/ Fédération des enseignantes-enseignants des écoles secondaires de l’Ontario (hereinafter called the ‘OSSTF/FEESO’) RE: Sick Leave The parties agree that any current collective agreement provisions and/or Board policies/practices/procedures related to Sick Leave that do not conflict with the clauses in the Sick Leave article in the Central Agreement shall remain as per August 31, 2014. Such issues include but are not limited to:

Care Professional to complete. From the date of this assessment, the above will apply for approximately: 6-10 days 11- 15 days 16- 25 days 26 + days Have you discussed return to work with your patient? Yes No Recommendations for work hours and start date (if applicable): Regular full time hours Modified hours Graduated hours Start Date: dd mm yyyy Is patient on an active treatment plan?: Yes No Has a referral to another Health Care Professional been made? Yes (optional - please specify): If a referral has been made, will you continue to be the patient’s primary Health Care Provider? No Yes No 4: Recommended date of next appointment to review Abilities and/or Restrictions: dd mm yyyy Completing Health Care Professional Name: (Please Print) Date: Telephone Number: Fax Number: Signature: RCDSB OSSTF-ECE Collective Agreement 2014-2017 / Extension Agreement 2017-2019 15 PART A – CENTRAL TERMS LETTER OF AGREEMENT #1 BETWEEN BETWEEN‌ The Council of Trustees’ Associations/ Le Conseil des associations d’employeurs (hereinafter called ‘CTA/CAE’) AND The Ontario Secondary School Teachers’ Federation/ Fédération des enseignantes-enseignants des écoles secondaires de l’Ontario (hereinafter called the ‘OSSTF/FEESO’) RE: Sick Leave Leave‌ The parties agree that any current collective agreement provisions and/or Board policies/practices/procedures related to Sick Leave that do not conflict with the clauses in the Sick Leave article in the Central Agreement shall remain as per August 31, 2014. Such issues include but are not limited to:

Care Professional to complete. From the date of this assessment, the above will apply for approximately: 6-10 days 11- 15 days 16- 25 days 26 + days Have you discussed return to work with your patient? Yes No Recommendations for work hours and start date (if applicable): Regular full time hours Modified hours Graduated hours Start Date: dd mm yyyy Is patient on an active treatment plan?: Yes No Has a referral to another Health Care Professional been made? Yes (optional - please specify): If a referral has been made, will you continue to be the patient’s primary Health Care Provider? No Yes No 4: Recommended date of next appointment to review Abilities and/or Restrictions: dd mm yyyy Completing Health Care Professional Name: (Please Print) Date: Telephone Number: Fax Number: Signature: RCDSB OSSTF-ECE Collective Agreement 2014-2017 15 PART A – CENTRAL TERMS LETTER OF AGREEMENT #1 BETWEEN BETWEEN‌ The Council of Trustees’ Associations/ Le Conseil des associations d’employeurs (hereinafter called ‘CTA/CAE’) AND The Ontario Secondary School Teachers’ Federation/ Fédération des enseignantes-enseignants des écoles secondaires de l’Ontario (hereinafter called the ‘OSSTF/FEESO’) RE: Sick Leave Leave‌ The parties agree that any current collective agreement provisions and/or Board policies/practices/procedures related to Sick Leave that do not conflict with the clauses in the Sick Leave article in the Central Agreement shall remain as per August 31, 2014. Such issues include but are not limited to:

Care Professional to complete. From the date of this assessment, the above will apply for approximately: 6-10 days 11- 15 days 16- 25 days 26 + days Have you discussed return to work with your patient? Yes No Recommendations for work hours and start date (if applicable): Start Date: dd mm yyyy Regular full time hours Modified hours Graduated hours Start Date: dd mm yyyy Is patient on an active treatment plan?: Yes No Has a referral to another Health Care Professional been made? Yes (optional - please specify): No If a referral has been made, will you continue to be the patient’s primary Health Care Provider? No Yes No 4: Recommended date of next appointment to review Abilities and/or Restrictions: dd mm yyyy Completing Health Care Professional Name: (Please Print) Date: Telephone Number: Fax Number: Signature: Please send completed form to CONFIDENTIAL fax 000-000-0000 Health and Wellness Officer Avon Maitland District School Board LETTER OF AGREEMENT #1 BETWEEN The Council of Trustees’ Associations/ Le Conseil des associations d’employeurs (hereinafter called ‘CTA/CAE’) AND The Ontario Secondary School Teachers’ Federation/ Fédération des enseignantes-enseignants enseignantes‐enseignants des écoles secondaires de l’Ontario (hereinafter called the ‘OSSTF/FEESO’) RE: Sick Leave The parties agree that any current collective agreement provisions and/or Board policies/practices/procedures related to Sick Leave that do not conflict with the clauses in the Sick Leave article in the Central Agreement shall remain as per August 31, 2014. Such issues include but are not limited to:)

Care Professional to complete. From the date of this assessment, the above will apply for approximately: 6-10 days 11- 15 days 16- 25 days 26 + days Have you discussed return to work with your patient? Yes No Recommendations for work hours and start date (if applicable): Regular full time hours Modified hours Graduated hours Start Date: dd mm yyyy Is patient on an active treatment plan?: Yes No Has a referral to another Health Care Professional been made? Yes (optional - please specify): If a referral has been made, will you continue to be the patient’s primary Health Care Provider? No Yes No 4: Recommended date of next appointment to review Abilities and/or Restrictions: dd mm yyyy Completing Health Care Professional Name: (Please Print) Date: Telephone Number: Fax Number: Signature: LETTER OF AGREEMENT #1 1‌ BETWEEN The Council of Trustees’ Associations/ Le Conseil des associations d’employeurs (hereinafter called ‘CTA/CAE’) AND The Ontario Secondary School Teachers’ Federation/ Fédération des enseignantes-enseignants des écoles secondaires de l’Ontario (hereinafter called the ‘OSSTF/FEESO’) RE: Sick Leave Leave‌‌ The parties agree that any current collective agreement provisions and/or Board policies/practices/procedures related to Sick Leave that do not conflict with the clauses in the Sick Leave article in the Central Agreement shall remain as per August 31, 20142019. Such issues include but are not limited to:

Care Professional to complete. From the date of this assessment, the above will apply for approximately: ☐ 6-10 days ☐ 11- 15 days ☐ 16- 25 days ☐ 26 + days Have you discussed return to work with your patient? ☐ Yes ☐ No Recommendations for work hours and start date (if applicable): ☐ Regular full time hours ☐ Modified hours ☐Graduated hours Start Date: dd mm yyyy Is patient on an active treatment plan?: ☐ Yes ☐ No Has a referral to another Health Care Professional been made? ☐ Yes (optional - please specify): ☐ No If a referral has been made, will you continue to be the patient’s primary Health Care Provider? No ☐ Yes ☐ No 4: Recommended date of next appointment to review Abilities and/or Restrictions: dd mm yyyy Completing Health Care Professional Name: (Please Print) Date: Telephone Number: Fax Number: Signature: LETTER OF AGREEMENT #1 BETWEEN The Council of Trustees’ Associations/ Le Conseil des associations d’employeurs (hereinafter called ‘CTA/CAE’) AND The Ontario Secondary School Teachers’ Federation/ Fédération des enseignantes-enseignants des écoles secondaires de l’Ontario (hereinafter called the ‘OSSTF/FEESO’) RE: Sick Leave The parties agree that any current collective agreement provisions and/or Board policies/practices/procedures related to Sick Leave that do not conflict with the clauses in the Sick Leave article in the Central Agreement shall remain as per August 31, 2014. Such issues include but are not limited to:

Care Professional to complete. From the date of this assessment, the above will apply for approximately: 6-10 days 11- 15 days 16- 25 days 26 + days Have you discussed return to work with your patient? Yes No Recommendations for work hours and start date (if applicable): Regular full time hours Modified hours Graduated hours Start Date: dd mm yyyy Is patient on an active treatment plan?: Yes No Has a referral to another Health Care Professional been made? Yes (optional - please specify): If a referral has been made, will you continue to be the patient’s primary Health Care Provider? No Yes No 4: Recommended date of next appointment to review Abilities and/or Restrictions: dd mm yyyy Completing Health Care Professional Name: (Please Print) Date: Telephone Number: Fax Number: Signature: OSSTF EDUCATIONAL SUPPORT STAFF SUPERIOR GREENSTONE DISTRICT SCHOOL BOARD LETTER OF AGREEMENT #1 BETWEEN The Council of Trustees’ Associations/ Le Conseil des associations d’employeurs (hereinafter called ‘CTA/CAE’) AND The Ontario Secondary School Teachers’ Federation/ Fédération des enseignantes-enseignants des écoles secondaires de l’Ontario (hereinafter called the ‘OSSTF/FEESO’) RE: Sick Leave The parties agree that any current collective agreement provisions and/or Board policies/practices/procedures related to Sick Leave that do not conflict with the clauses in the Sick Leave article in the Central Agreement shall remain as per August 31, 2014. Such issues include but are not limited to:)

Care Professional to complete. From the date of this assessment, the above will apply for approximately: 6-10 days 11- 15 days 16- 25 days 26 + days Have you discussed return to work with your patient? Yes No Recommendations for work hours and start date (if applicable): Regular full time hours Modified hours Graduated hours Start Date: dd mm yyyy Is patient on an active treatment plan?: Yes No Has a referral to another Health Care Professional been made? Yes (optional - please specify): If a referral has been made, will you continue to be the patient’s primary Health Care Provider? No Yes No 4: Recommended date of next appointment to review Abilities and/or Restrictions: dd mm yyyy Completing Health Care Professional Name: (Please Print) Date: Telephone Number: Fax Number: Signature: LETTER OF AGREEMENT #1 BETWEEN The Council of Trustees’ Associations/ Le Conseil des associations d’employeurs (hereinafter called ‘CTA/CAE’) AND The Ontario Secondary School Teachers’ Federation/ Fédération des enseignantes-enseignants des écoles secondaires de l’Ontario (hereinafter called the ‘OSSTF/FEESO’) RE: Sick Leave Leave‌ The parties agree that any current collective agreement provisions and/or Board policies/practices/procedures related to Sick Leave that do not conflict with the clauses in the Sick Leave article in the Central Agreement shall remain as per August 31, 2014. Such issues include but are not limited to: