Disability questionnaire sample
[DOC File]POST –JOB OFFER MEDICAL HISTORY QUESTIONNAIRE
https://info.5y1.org/disability-questionnaire-sample_1_d6830f.html
This Medical History Questionnaire is required of all employees who have been given a conditional offer of employment with this worksite employer. ... terms of the Americans with Disabilities Act and will not be used to discriminate against qualified individuals with a disability in any phase of employment, including hiring, advancement ...
[DOC File]The Oswestry Disability Index (ODI) Version 2
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Oswestry Low Back Pain Disability Questionnaire. Oswestry Disability Index. Please complete this questionnaire. It is designed to tell us how your back pain affects your ability to function in every day life. I have “Chronic Pain” or pain that has bothered me for …
[DOC File]01 – Report Template Initial Assessments
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A-4 Vocational Exploration: A collaborative effort between counselor and client that considers transferable skills, impact of disability condition and residual functioning, vocational testing results, labor market conditions and demands, assistive technology and job modifications, need for services to improve independence in the home and ...
[DOC File]FUNCTIONAL CAPACITY QUESTIONNAIRE - Disability Attorney
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Title: FUNCTIONAL CAPACITY QUESTIONNAIRE Author: Pat Bretz Last modified by: Buck Created Date: 9/14/2013 12:29:00 AM Company: Mike Murburg, PA Other titles
[DOCX File]ADA aCCOMMODATION MEDICAL CERTIFICATION fORM
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During the interactive process, if appropriate, an employer may request medical documentation in support of an employee’s disability, any restrictions or barriers the employee may experience as a result of the disability, and any suggestions for potentially effective accommodations. This documentation must be provided by the employee.
[DOC File]QUESTIONNAIRE FOR CONSERVATORSHIP PETITION
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QUESTIONNAIRE FOR CONSERVATORSHIP PETITION. General Info for Petition. Petitioner. Name of Petitioner: _____ ... If Y, specify nature and degree of disability – Regional Center Client, Mental Age (Attachment 5f) _____ Limited Powers and Duties (Attachment 1h & 1j) – Circle powers requesting and indicate reason ...
[DOC File]DISABILITY RATING SCALE FOR LOW BACK PAIN
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DISABILITY RATING SCALE FOR LOW BACK PAIN. Canadian English version of the Roland-Morris disability questionnaire produced by MAPI in 2005. The cultural adaptation process is described in section 1.2 of the translation section at the end of the questionnaire. When your back hurts, you may find it difficult to do some of the things you normally do.
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