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Get Ok Workers Compensation Return To Work Form 2021-2025

Appt. Date: SSN: Date of Injury: Employer: Brief diagnosis of injury/illness: RETURN TO WORK STATUS Release: (check only one) 1. Patient is unable to return to work. 2. Full Duty Release: employee has reached maximum medical improvement (MMI) and is released from active medical care. 3. Full Duty Releas.

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