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Customer Service: 1-877-564-2333

(7am-6pm Central, M-F)

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Fitness of Duty Form

Fitness of Duty Form (019441)

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Fitness of Duty Form

Medical information for an employee who is looking to return to work. Read more.

$0.19

View Volume Pricing & Product Codes

Version

Product Code: 68169

List Price: $0.19

Drug & Alcohol Clearinghouse Consent Form for Limited Queries, Snap-Out Format

Drug and Alcohol FMCSA Clearinghouse forms are 2-ply and carbonless.

Driver's Application for Employment - ADA-Compliant

Helps meet requirements of 49 CFR Section 391.21 and the ADA.

4.0-Star Rating

(1)

Driver Qualification File Folder - For Two-Copy Forms

Helps keep required Driver Qualification forms organized and secure.

4.3-Star Rating

(3)

Overview Pricing Specification Related Solutions Q&A Reviews

Overview

Statement of physician or practitioner to return to work
Maintain this form in FMLA confidential file
Measures 8-1/2” x 11”
Printed on quality bond paper
English only
Made in the USA

Volume Pricing

Volume Pricing
Product Code	Description	1 - 4	5 - 9	10 - 24
Higher quantities available. Pricing reflected in shopping cart or call 1-877-564-2333 to order.
68169	Fitness for Duty, 8-1/2" x 11"	$0.19	$0.18	$0.17

Specification

Specification
Product Code	Description	Format	Size	Material	Country Of Origin
68169	Fitness for Duty, 8-1/2" x 11"	Sheet	8-1/2" x 11"	Quality Bond Paper	USA

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Product Questions & Answers

Product Reviews