Employee Return to Work Form Your Name* First Last Branch*BrandonCalgaryCentral WarehouseChathamCorporateEdmontonGrande PrairieLangleyLethbridgeLloydminsterMississaugaOakbluffRed DeerReginaSarniaSaskatoonSudburyThunder BayWinnipegEmployee Name* First Last Title*Counter SalesAM SalesTrailer SalesParts HandlerShipper/ReceiverMechanic/TechDriverAdminManagerOtherOther (Please detail) Date of Return* MM slash DD slash YYYY Reason for Return*Recovered - Confirmed not COVID-19Recovered - Symptom Free w/o Meds for 3 DaysChildcare ResolvedIsolation CompleteOther (please include details below)Other (Details)Notes
