Serving Schools Since 1980 - Alpine | Amador | Calaveras | Tuolumne

Physician Consent for Fit-for-Duty Test

Physician Consent for Fit-for-Duty Test

by | Feb 14, 2025

This Physician Consent for Fit-for-Duty Test form is required for employees undergoing a WorkSTEPS® physical capacity evaluation as part of the district’s employment policy. The test assesses posture, joint range of motion, strength, dynamic lifting, and...
Medical Release Authorization Form

Medical Release Authorization Form

by | Feb 14, 2025

This Medical Release Authorization Form allows individuals to authorize the disclosure of medical records for purposes related to workers’ compensation claims, legal cases, or personal medical history review. The form grants permission to healthcare providers,...
Medical Mileage Expense Reimbursement Form

Medical Mileage Expense Reimbursement Form

by | Feb 14, 2025

The Medical Mileage Expense Reimbursement Form allows employees to request reimbursement for travel costs incurred when seeking medical treatment for a work-related injury or illness. Employees may claim mileage expenses at the current reimbursement rate ($0.67 per...
Employee-Supervisor Incident Report

Employee-Supervisor Incident Report

by | Feb 14, 2025

The Employee-Supervisor Incident Report is a mandatory form for documenting workplace injuries, exposures, or safety concerns. Employees must complete and return this form to their supervisor within 72 hours, detailing the time, location, and nature of the incident,...