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Get and Sign Work Restriction Form 2008-2022

Get and Sign Work Restriction Form 2008-2022

Use a work restrictions form 2008 template to make your document workflow more streamlined.

Time for a total of with a break of sitting standing walking STRENGTH please use letters to indicate frequency N Never O Occasional under 2-1/2 hours F Frequent 2-1/2 to 5 hours Hand/Foot Movement Weight in Lbs. to 10 11-20 21-50 51-75 Lift/Carry Below Waist C Continuously over 5 hrs N O F C Kneel Bend Squat Climb Repetitive hand movements Push/Pull Foot controls Above Shoulder Finger/fine manipulation Power grasp 8 of force Waist/Chest Simple grasp 8 of force Reach Above Shoulders At or...
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