2026/Mar/24 2:02:13 PM

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if answers no, please provide prognosis for Gradual Return to Work/Return to Work, and start date.

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Please provide more information regarding specific restrictlons or limitations that may Impact the
employee's ability to carry out the bona fide requirements of their role as set out in the JOA (attached).

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Are there any other factors related to the employee's condition you feel we shauld be made aware of

which may impact thelr abllity to carry out their work duties?

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