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BCRTC_MEDICAL_QUESTIONARE — p.4
📄 BCRTC MEDICAL QUESTIONARE | p.4
📝 Extracted Text (OCR)
Bort ‘a.

OCCUPATIONAL FITNESS ASSESSMENT (OFA)
CONFIDENTIAL INFORMATION (To be completed by attending physician)

Guideway Serviceperson

Employee Name: Employee #:
Mark Holand E21987
Job Title: Date of Birth:

X]Safety Critical

Safety Sensitive

Please refer to Canadian Railway Medical Rules Handbook for Positions Critical to Safe Railway Operations,
https://www.railcan.ca/publication/canadian-railway-medical-rules-handbook/

Give that the employee did not sustain a physical injury, please provide additional information regarding

the rationale and need for lifting and walking limitations.

Can the employee perform office-based, administrative work without restrictions as part of a gradual

return to work? If so, please provide an anticipated start date.

If no, please provide rationale:

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