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

Mark Holand
Job Title:
Guideway Serviceperson
Gisafety Critical © OSafety Sensitive
Please refer to Canadian Railway Medical Rules Handbook for Positians Critical to Safe Railway Operatlo

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Employee #:
£21987
Date of Birth:

Give that the employee did not sustain a physical Injury, please provide additional informatian regarding
the rationale and need for lifting and walking limitations.

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Can the emplayee 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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