Sample Return to Work Report Return to Work Report for XYZ Company Report Print Date: 7/9/2013 Return to Work Date: 7/9/2013 - 7/16/2013 Last Name First Name RTW Preferred Notification Method Phone Email Employee No Leave No Leave Frequency Leave Start Date Planned End Date End of Leave Status Leave Plans Primary Contact Primary Contact Email FMLA Cindy Email 317-431-4410
[email protected] 1234 762962 CLOA 06/13/2013 07/16/2013 End of Leave Approaching FMLA Sue Smith
[email protected] Leave Cathy Email 765-481-0516
[email protected] 2341 776397 ILOA 06/26/2013 07/09/2013 End of Leave Confirmed FMLA John Brown
[email protected] Absence Adam Phone 773-297-5555 N/A 3412 789789 CLOA 06/26/2013 07/09/2013 End of Leave Unconfirmed FMLA John Brown
[email protected]