MEDICAL WORK RESTRICTION AGREEMENTRestriction Agreement • July 19th, 2007
Contract Type FiledJuly 19th, 2007I, the undersigned, have been advised that medical restrictions have been placed on my activities while performing duties within the scope of my employment. I have read and understand the medical restrictions as detailed above. I further understand that it is my responsibility not to violate these restrictions. I further understand and agree that if a supervisor requests that I perform duties that would violate these restrictions; I will immediately advise that supervisor and other management, if necessary, of my restrictions. I further agree to keep my scheduled doctor appointments and keep my supervisor informed in the event my doctor changes these restrictions.