From RMIDentalSuccess.com - Dentistry's Finest Online Provider of Practice-Building Services
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Monday, January 29, 2007
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Issue 246
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VOLUME 1
ISSUE 246
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Sample Return To Work Form – Pregnancy Disability Leave Letter.
 By Roz Fulmer, Dental Advisor.
This week I would like to share with you a sample “Return To Work Form – Pregnancy Disability Leave Letter” that you can use with your team members:
Dear,
We hope you and your new baby are doing well and we send your family our best wishes.
The purpose of this letter is to advise you of your rights based on our state law of (name of State) as it relates to maternity leave. As you may know, you are entitled to up to four months of pregnancy disability leave for disabilities relating to pregnancy and childbirth.
According to our records, your last day of work was ________________ which means that your four months of leave will be up as of __________________, is that correct? We are required to hold your position open for you through the period of your pregnancy disability leave up to four months and we are doing that per our agreement. Are you still in agreement that you will be returning to your position by __________________? Please let me know if you will be able to report to work at the end of your leave at least two weeks prior to that date.
We have appreciated your contributions to the practice and look forward to hearing from you. We also can not wait to have you back as part of our team.
Sincerely,
Provider’s Name
If you liked this document, Roz has many others in her new “Letter Book.” If you are interested in getting her book send an email to gregs@rmidentalsuccess.necom. Please type “Roz’s Letter Book” in the Subject box and includeyour address, phone and fax number in your message.Or call 800-460-3838 x106. Or Fax this page to 801-293-8524 after completing the contact information below.
Name: ___________________________________________
Address: _________________________________________
Phone: _________________ Fax: _____________________
Email: ____________________________________________
For a complete list of the products and services that are endorsed by RMI Dental Success and the Crown Council click here: www.rmidentalsuccess.com
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