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Employee In-Person Work Form
Pursuant to the Michigan Occupational Safety and Health Administration (MIOSHA) Emergency Rules, in-person work for employees is prohibited “to the extent that their work activities can feasibly be completed remotely.” If you are able to perform your duties remotely but plan to continue to work in-person at your building, please complete this form below:
Employee Name *
Job Title *
Building *
Days in which you plan to work in-person (please complete each week you plan to work) *
Required
Please select the reason you plan to work in-person *
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