Medical Statement. A statement from the professor’s physician as to the beginning date of the leave and anticipated return to service shall be filed with the district at least 30 days prior to the anticipated start date of the unpaid leave, if possible.
Medical Statement. An employee will provide, at the time of the leave application, a statement from the attending physician indicating the expected date of delivery.
Medical Statement. Any employee desiring consideration for sick leave benefits may be required to file with the University either a physician's statement or a sworn affidavit, at the University's election, that the claim for sick leave is bona fide. Until such statement is filed, if requested, all absences will be considered as lost time, and the employee's pay will be reduced accordingly.
Medical Statement. The teacher shall advise the Superintendent or his/her designee of the fact of pregnancy no later than the fourth month of pregnancy. At such time she shall provide a written statement from her obstetrician or physician indicating the expected date of delivery and that in his/her opinion the teacher may safely continue in her employment and perform all her regular teaching duties during her pregnancy. From time to time the Superintendent or his/her designee may request the teacher to furnish subsequent statements from the doctor indicating her continued ability to perform her teaching duties. At the district’s request and expense, the teacher may be required to have a physical examination by a physician of mutual choice.
Medical Statement. The Superintendent may, at any time, require an employee of the Board to furnish a certificate from a licensed medical physician (not a chiropractor), stating that he/she is physically and mentally qualified to fulfill required duties or to return to work after a sick leave. The examination may be made by the employee's own physician; however, the Board reserves the right to designate a physician to make the examination.
Medical Statement a request for a medical leave of absence, or renewal thereof, shall be accompanied by a written medical statement from the teacher’s attending physician outlining the personal illness or disability requiring a leave and estimated time of which the teacher is expected to be able to return to duty. A teacher must also submit a release to return to work from their attending physician prior to returning to duty.
Medical Statement. A teacher will provide, at the time of the leave application, a statement from the attending medical provider indicating the expected date of delivery when appropriate.
Medical Statement. A pregnant employee will provide, at the time of the leave application, a statement from her physician indicating the expected date of delivery.
Medical Statement. I understand that Willamette Valley Balloons, LLC may not fly me if I am pregnant, have a heart condition, back problems, casts, recent surgeries, or any other condition that might make it unsafe for me to fly. I certify that I have no physical or mental defect/condition which prevents me from participating in hot air ballooning and related activities. I further certify that I am in good physical condition or have consulted with my physician and I am able to participate in hot air ballooning activities.
Medical Statement. I understand and acknowledge that the Parachute Activities are strenuous, athletic activities, requiring me to be in good physical condition. I hereby certify that I understand that the LJT has strongly recommended that all of its members secure an annual physician's examination using the form set forth in Attachment ‘A’ to verify current fitness for Parachute Activities and that the responsibility to act on that recommendation is mine alone. Liberty Jump Team Inc. recognizes the importance of a annual physician’s check up, utilizing the attached Medical Examination Form or comparable from signed by the physician. I hereby certify that I do not suffer from any physical conditions or chronic illness which would affect my ability to engage in the particular Parachute Activities in which I become involved, including, but not limited to, any of the following conditions: cardiac or pulmonary condition or disease, abnormal blood pressure, fainting spells, convulsions, hearing loss or impairment, nervous disorders, diabetes, kidney or related diseases, or shortness of breath. I further certify that I am taking no regular medication which would impair or decrease my judgment or ability to engage in the Parachute Activities. Further, I understand and agree that it is a violation of federal, state, and/or local law to consume alcoholic beverages or drugs within the previous eight hours of any Parachute Activity and I therefore agree to refrain from such consumption. I UNDERSTAND THAT I HAVE THE FINAL RESPONSIBILITY FOR MY OWN SAFETY. INITIAL I am submitting Attached form ‘A’ or a comparable Medical form signed by my physician I agree as follows:
