RETURN TO WORK

SFRHRD-036 V2 · Effective Date: April 2025

Name

Date Prepared

Position

Machine / Location

Department

Immediate Superior

From Suspension

From Sick Leave / Emergency Leave

Fit to Work Clearance FTW Date:

Documentation to justify emergency leave / authorized absence

File Link (e.g. Google Docs)/Reason:

I hereby attest that the attached Medical Certificate and Fit to Work (FTW) Clearance and/or documentation to justify my emergency leave / authorized absence are authentic.

Employee Signature over Printed Name:

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Created	Employee / Position	Dept	Return Type	FTW Status	HR Acknowledgment	Supervisor Review	Manager Recommend	Director Approval	Load RTW	Copy Link
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