2026/Mar/26 1:50:30PM  16043985614->555-1212 40

Mar 26, 2026 01:45 To: +16046205552 Page:.04/10 From: Foremed Medical Clinic Fax: 16043985614
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ifanswerisno, please provide prognasis for Gradual Return ta Work/Return ta Work, and start.date-
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Please provide more information segarding specific restrictions or limitations that may Impact the
employee's ability to carry out the bona fide requirements of their role as set outin the JDA (attached).

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Are there any other factors related te the employee's condition yau feel we should be made-awere of

which may impact thelr ability ta carry out their work duties?

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