Case number: .us
Employee: | |House: | | |
|Modified start date: | |Release date: | |
| | | | |
Questions to ask when gathering modified work assignments information:
| |Specify doctors restrictions: | |
| | | |
| | | |
| |Do you have lifting restrictions: |Yes No Weight limitation: |
| |Can you walk up/down stairs: |Yes No |
|Office skills |Be specific: |
|Basic office skills |a. |Do you have filing skills (alpha and numerical)? |Yes | |No | |
| |b. |Do you have phone / receptionist skills? |Yes | |No | |
| |c. |Do you have VISA (SPOTS) Card reconciliation experience? |Yes | |No | |
| |d. |Do you have Petty Cash reconciliation experience? |Yes | |No | |
| |e. |Mail sorting? Yes No Copy machine experience? |Yes | |No | |
| |
|Computer skills |Yes No |
| |
|Computer programs used |a. |MS Word experience |Yes | |No | |
| |b. |Excel / spread sheet experience |Yes | |No | |
| |c. |Access |Yes | |No | |
| |d. |OTHER: |
| |
|Organizational skills: |a. |Supply room sorting/organizational skills? |Yes | |No | |
| |b. |Experience setting up conference calls? |Yes | |No | |
| |c. |Experience setting up meetings via GroupWise? |Yes | |No | |
| |d. |Experience writing or preparing desk manuals? |Yes | |No | |
| |
|OTHER: |a. | |
| |b. | |
| |
NOTE: All modified workers are required to sign a confidentiality agreement regarding SOCP Central Office work.
Attire is business casual with work hours 8 a.m. to 5 p.m. A 1 hour lunch or when needed ½ hour is approved to allow for doctor’s appointments.
|Employee Signature: | |Date: | |
Remember all SOCP Central Office support staff duties and files are confidential.
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