[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-286737-105":53,"doc-detail-286737-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","return-to-work-authorization-form-human-resources","Return to Work Authorization Form - Human Resources","","The Return to Work Authorization Form is an official document utilized by District 120 to facilitate the transition of employees back to their professional duties following a medical absence. This comprehensive form requires input from both the employee and their licensed health care provider to ensure medical compliance and workplace safety. The provider must explicitly state whether the individual is cleared for full duty or requires specific accommodations. Furthermore, the form includes critical contact information for the Director of Human Resources for employees needing ADA-related support. It serves as a vital administrative bridge between medical professionals and the employer, ensuring that all return-to-work protocols are documented, signed, and processed through the Human Resources department at 1500 West Hawley Street, Mundelein, IL. This structured approach maintains institutional health standards while respecting the privacy and medical needs of the school district workforce.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/return-to-work-authorization-form-human-resources/286737/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/return-to-work-authorization-form-human-resources/286737.png","ImageObject",442,249,{"name":88,"@type":89},"Lucas Vance","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-23","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":79},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Who is responsible for completing the first section of this form?","Question",{"text":108,"@type":109},"The employee is responsible for completing the initial section, providing their first name, middle initial, and last name.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What should an employee do if they need an ADA accommodation?",{"text":113,"@type":109},"Employees requiring an accommodation under the Americans with Disabilities Act should contact the Director of Human Resources by calling (847) 949-2200 X1208 or emailing smccreery@d120.org.",{"name":115,"@type":106,"acceptedAnswer":116},"Where should the completed document be submitted?",{"text":117,"@type":109},"The completed form must be returned to the District 120 Human Resources office located at 1500 West Hawley Street, Mundelein, IL 60060.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},286737,1790100280,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":4},549768064622,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Return to Work Authorization Form  \nTo be completed by a licensed health care provider releasing the employee to return to work following a medical absence.  \nTO BE COMPLETED BY EMPLOYEE  \nFirst Name:   Middle Initial:   Last Name:    \nNote to Employee-If you believe you have a medical condition that is affecting your ability to perform the essential functions of your job and require an accommodation under the Americans with Disabilities Act, please contact the Director of Human Resources at (847) 949-2200 X1208 or by[emailing smccreery@d120.org](emailing smccreery@d120.org).  \nTO BE COMPLETED BY THE HEALTH CARE PROVIDER  \nProvider’s Name:    \nProvider’s Business Address:    \nType of Practice/Medical Specialty:    \nTelephone: (  )   Fax: (  )    \nThe individual listed above has been released to:  \n Return to work full duty with no work restrictions as of this date   /   / 20   Return to work WITH the following restrictions:  \n\n|  |\n| --- |\n|  |\n\nSignature of Health Care Provider:   Date:    \nReturn this completed form to District 120 Human Resources, 1500 West Hawley Street, Mundelein, IL 60060","cbCaimKyLj8nnwG0","https://ap.wps.com/l/cbCaimKyLj8nnwG0","pdf",81769,"English","# Employee Information\n## Health Care Provider Details\n## Work Duty Status\n## Human Resources Contact Information","[{\"question\":\"Who is responsible for completing the first section of this form?\",\"answer\":\"The employee is responsible for completing the initial section, providing their first name, middle initial, and last name.\"},{\"question\":\"What should an employee do if they need an ADA accommodation?\",\"answer\":\"Employees requiring an accommodation under the Americans with Disabilities Act should contact the Director of Human Resources by calling (847) 949-2200 X1208 or emailing smccreery@d120.org.\"},{\"question\":\"Where should the completed document be submitted?\",\"answer\":\"The completed form must be returned to the District 120 Human Resources office located at 1500 West Hawley Street, Mundelein, IL 60060.\"}]","Return to Work Authorization Form - Human Resources | PDF",1789631492]