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Office of Human Resources

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Total Rewards: Benefits & Pay
- Total Rewards goes beyond basic benefits
  Total Rewards is the holistic way we reward our employees. It includes compensation, healthcare plans, tuition benefits, retirement plans, and so much more.
  
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Professional Success
- Be a life-long learner
  Each year, we provide thousands of hours worth of in-person and online learning & professional development programs. This helps our employees and managers keep up with skills, expand their knowledge, and work better together.
  
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  We’re here to support you in all things related to working at the University of Rochester. If you have a question or need help finding or completing a document, our contact page will point you in the right direction.
  
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Return to Work from Leaves Form

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Total Rewards: Benefits & Pay
Leave and Disability
Return to Work from Leaves Form

Employee Information
Name: * Required
Employee ID: * Required
Return to Work Date: * Required

MM slash DD slash YYYY
Return from: * Required
- Leave of Absence
- Short-Term Disability
- Long-Term Disability
- Workers' Compensation
- Paid Family Leave–Continuous leave
Limit to
- Limit to
Restrictions
Nursing Practice Member:
- Nursing Practice Member
hours per day

hours per day
Movement
- Twisting
- Bending
- Limit lifting to
Hidden

Pounds

pounds
Motion
- Repetitive Motion
- Other:
additional information
Date to end Restrictions:

MM slash DD slash YYYY
Information
Reporter's email address: * Required

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