Signature: Date: …………………………………………........ ……………………… Print Manager’s Name: ……………………………………………………………………… Signature: Date: …………………………………………........ ……………………… Manager Action: ……………………………………………………………………………… Insert date notified the Workforce Transactional Team of date of Return to Work via web based system
Signature: …………………………………………........ Date: ……………………… Print Manager’s Name: ……………………………………………………………………… Signature: …………………………………………........ Date: ……………………… Manager Action: ……………………………………………………………………………… Insert date notified the Workforce Transactional Team of date of Return to Work via web based system