rmp Unfit for Duty PCP letter

Dear [text name="doctors"],

I am the Medical Director of AHN Employee Health Services, and recently had to take you patient [text name="firstname"] [text name="lastname"] off work. [text name="upper_he_she" default="He"] was referred to me for a fitness for duty evaluation because of multiple problems in the workplace which interfered with the performance of her job. These included:
[checkbox name="problem_1" value="- "][conditional field="problem_1" condition="(problem_1).is('- ')"] [text name="problem_1_name"] [/conditional]
[checkbox name="problem_2" value="- "][conditional field="problem_2" condition="(problem_2).is('- ')"] [text name="problem_2_name"] [/conditional]
[checkbox name="problem_3" value="- "][conditional field="problem_3" condition="(problem_3).is('- ')"] [text name="problem_3_name"] [/conditional]
[checkbox name="problem_4" value="- "][conditional field="problem_4" condition="(problem_4).is('- ')"] [text name="problem_4_name"] [/conditional]

[text name="upper_his_her" default="His"] medical history is well-known to you. My evaluation, pertinent to the reported problems, was notable for [text name="findings"]. 

Given these findings, it was clear that [text name="lower_he_she"] was not fit for duty, so I had to take [text name="lower_him_her"] off work and recommended that [var name="lower_he_she"] see you promptly to get whatever evaluation and/or treatment you deem necessary. When you are satisfied that the underlying concern has been addressed (or is no longer an issue), please write a letter indicating that the [var name="lower_he_she"] can safely return to work (with accommodations if needed). [There are further details in the "Return to Work" instructions.]

I am writing to let you know because [var name="lower_he_she"] will be contacting your office soon for follow-up, because Employee Health medical records are not visible in Epic, and because [var name="lower_he_she"] will be applying for Short-Term Disability while [var name="lower_he_she"] is unable to work. (I am not allowed to complete that paperwork; it must be completed by a provider who is treating [var name="lower_him_her"].)

I will separately fax you a copy of my evaluation, return to work instructions, and @lower_his_her job description. Please let me know if you have any questions.

Sincerely, 

Randolph Peters, MD 
Medical Director
AHN Employee Health Services