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Functional Abilities Form - yyzdistrict301.com

FunctionalAbilities form for Planning Early and Safe Return to Work Health Professionals, please use this form ONIY when requested by an employer or worker. The purpose of this form is to identify your patient's overall Functional Abilities and work restrictions that will assist his/her return to suitable work. Your promptness in completing this form is key in assisting the employer and worker to plan an early and safe return to work. Please provide the completed pages 2 and 3. to the worker and/or employer. Authority to Release Information Section37(3) of the WorkplaceSafetyand InsuranceAct,7997 providesthe legalauthorityfor healthprofessionals to givethe WorkplaceSafetyand InsuranceBoard(WSIB), the injuredworkerand the employersuch informationas may be prescribedconcerningthe worker'sfunctionalabilities.

Functional Abilities Form for Planning Early and Safe Return to Work Health Professionals, please use this form ONIY when requested by an employer or worker.

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