Get a Form or Publication: medical restrictions

Your search for "medical restrictions" returned 2 documents.

Title Type Number
Insurer Activity Prescription Form
Also available in: English/Spanish

Used by health-care providers to communicate an injured worker's status, physical capacities, inability to work (time-loss) and treatment plans. To print an APF, click on the title of the form in the box above.

Form F242-385-000
Preferred Worker Employers Job Decsription

Used by the employer to describe the job for the preferred worker. This form is reviewed by a vocational services consultant to ensure that the offered job is consistent with the worker's medical restrictions.

Form F280-022-000



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