The Work Release form is a document that allows individuals to leave a correctional facility temporarily for employment purposes. This form is essential for those seeking to reintegrate into society while maintaining their job responsibilities. Understanding its requirements and process can significantly impact a person's transition back into the workforce.
The Work Release form is an essential document that plays a vital role in the intersection of employment and legal obligations. Designed to facilitate the temporary release of individuals from incarceration for work-related purposes, this form serves multiple functions. It allows eligible participants to maintain their employment, support their families, and reintegrate into society while fulfilling their legal requirements. Typically, the form includes sections for personal information, details about the job, and the duration of the work release. Additionally, it often requires signatures from both the individual and the supervising authority, ensuring that all parties are aware of the terms and conditions involved. Understanding the nuances of the Work Release form can empower individuals navigating the complexities of their legal situations, providing them with a pathway to balance their responsibilities and opportunities for growth. With the right information, anyone can grasp the importance of this form in promoting rehabilitation and reducing recidivism, ultimately benefiting both individuals and communities alike.
Return to Work Release and Work Ability
Employee Name: __________________________________________
Return to Work
Return to work with no limitations on ________/________/__________
Return to work with limitations on _________/_________/__________ (note limitations below)
Employee’s Capabilities
Not
Occasio
Freque
Continuo
at
nal
nt
us
Lift/Carry
all
0-33%
34-66%
67-100%
0-9 lbs
10-19 lbs
20-29 lbs
30-39 lbs
40-49 lbs
No lifting
Push/Pull without resistance
0-19 lbs
20-40 lbs
> 40 lbs
Bend
Twist/turn
Kneel/squat
Sit
Stand/walk
Ladder/stair
climb
Hand, wrist, and shoulder activities
Avoid prolonged, repetitive, or forceful:
Gripping/grasping
Repetitive wrist
motion
Reaching
Above
shoulder
At shoulder
height
Below
This treatment has been discussed with the employee.
Restrictions (circle)
Keyboarding / hrs
0
1 - 2
3 – 4
5 – 6
7+
Writing / hrs
Change positions every:
As needed
Half hour
One hour
Two hours
Worksite stretches
Exercises
Other
Comments:
_________________________________________________
__________________________
Physician Signature
Date
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When filling out and using the Work Release form, it is important to keep several key points in mind to ensure a smooth process.
By adhering to these key takeaways, individuals can navigate the Work Release process more effectively.