Care Professional Sample Clauses

Care Professional. The following information should be completed by the Health Care Professional Please check one: Patient is capable of returning to work with no restrictions. Patient is capable of returning to work with restrictions. Complete section 2 (A & B) & 3 I have reviewed sections 2 (A & B) and have determined that the Patient is totally disabled and is unable to return to work at this time. Complete sections 3 and 4. Should the absence continue, updated medical information will next be requested after the date of the follow up appointment indicated in section 4. First Day of Absence: General Nature of Illness (please do not include diagnosis): Date of Assessment: dd mm yyyy 2A: Health Care Professional to complete. Please outline your patient’s abilities and/or restrictions based on your objective medical findings. PHYSICAL (if applicable) Walking: Full Abilities Up to 100 metres 100 - 200 metres Other (please specify): Standing: Full Abilities Up to 15 minutes 15 - 30 minutes Other (please specify): Sitting: Full Abilities Up to 30 minutes 30 minutes - 1 hour Other (please specify): Lifting from floor to waist: Full Abilities Up to 5 kilograms 5 - 10 kilograms Other (please specify):
Sample 1Sample 2Sample 3See All (8)
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Care Professional. The following information should be completed by the Health Care Professional First Day of Absence: General Nature of Illness (please do not include diagnosis): Date of Assessment: dd mm yyyy 2A: Health Care Professional to complete. Please outline your patient’s abilities and/or restrictions based on your objective medical findings. PHYSICAL (if applicable) Walking: Full Abilities Up to 100 metres 100 - 200 metres Other (please specify): Standing: Full Abilities Up to 15 minutes 15 - 30 minutes Other (please specify): Sitting: Full Abilities Up to 30 minutes 30 minutes - 1 hour Other (please specify): Lifting from floor to waist: Full Abilities Up to 5 kilograms 5 - 10 kilograms Other (please specify):
Sample 1Sample 2Sample 3
Care Professional. The following information should be completed by the Health Care Professional First Day of Absence: General Nature of Illness (please do not include diagnosis): Date of Assessment: dd mm yyyy 2A: Health Care Professional to complete. Please outline your patient’s abilities and/or restrictions based on your objective medical findings. PHYSICAL (if applicable) Walking ☐ Full Abilities ☐ Up to 100 metres ☐ 100 - 200 meters ☐ Other (please specify): Standing: ☐ Full Abilities ☐ Up to 15 minutes ☐ 15 - 30 minutes ☐ Other (please specify): Sitting: ☐ Full Abilities ☐ Up to 30 minutes ☐ 30 minutes – 1 hour ☐ Other (please specify): Lifting from floor to waste: ☐ Full Abilities ☐ Up to 5 kilograms ☐ 5 - 10 kilograms ☐ Other (please specify): Lifting from Waste to Shoulder: ☐ Full Abilities ☐ Up to 5 kilograms ☐ 5 - 10 kilograms ☐ Other (please specify): Stair Climbing: ☐ Full Abilities ☐ Up to 5 steps ☐ 6 - 12 steps ☐ Other (please specify): Use of Hand(s): Left Hand Right Hand ☐ Gripping ☐ Gripping ☐ Pinching ☐ Pinching ☐ Other (please specify): ☐ Other (please specify): ☐ Bending/twisting repetitive movement of (please specify) ☐ Work at or above shoulder activity: ☐ Chemical exposure to: Travel to Work: Ability to use public transit Ability to drive car ☐ Yes ☐ No ☐ Yes ☐ No
Sample 1

Related to Care Professional

  • Other Professional Services We will provide you the various implementation-related services itemized in the Investment Summary and described in the Statement of Work.

  • 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 Ontario Public School Boards’ Association (hereinafter called ‘OPSBA’) AND The Ontario Secondary School Teachers’ Federation (hereinafter called the ‘OSSTF’)

  • Professional Dues The school district will pay the annual dues for the Superintendent’s membership in the American Association of School Administrators, Association for Supervision and Curriculum Development, and Nebraska Council of School Administrators. The Superintendent’s membership in other professional organizations will be considered annually and may be approved at the discretion of the school board.

  • Scope of Professional Services 3.1 On the terms and conditions set forth in this Agreement, COUNTY hereby engages CONTRACTOR to provide all labor, materials and equipment to complete the Project/Service in accordance with the Scope of Services, attached hereto and incorporated herein as Attachment A, as modified or clarified by Addendum(s) # , dated , attached hereto and incorporated herein by reference as Attachment B. It is understood that the Scope of Services may be modified by change order as the Project/Service progresses, but to be effective and binding, any such change order must be in writing, executed by the parties, and in accordance with the COUNTY’s Purchasing Policies and Procedures. A copy of these policies and procedures shall be made available to the CONTRACTOR upon request.

  • Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit, as applicable.

  • Professional Dress In as much as teachers are role models for students, each teacher shall maintain a neat, professional appearance appropriate for his/her specific teaching assignment.

  • PROFESSIONAL BEHAVIOR A. Teachers are expected to comply with reasonable rules, regulations, and directions adopted by the Board, or its representatives, which are not inconsistent with the provisions of this Agreement, provided that a teacher may reasonably refuse to carry out an order which threatens physical safety or well being or is professionally demeaning.

  • Professional Services Bodily injury" or "property damage" arising out of the rendering of or failure to render profes- sional services;

  • Professional Learning A. School-based Professional Learning

  • Professional Service Consultant agrees that all services and work performed under this agreement will be accomplished in a professional manner, in accordance with the accepted standards of Contractor’s profession.

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