Address:1 Bakehouse Road

Lloyd Street Business Estate

Kensington VIC 3031
Tel: 03) 93721012

Fax: 03) 9372 1010

Email:

Belmax Services Pty Ltd: A.B.N 45 074 078 523

Registered Electrical Contractors: 10617

Dear Doctor ______

MPE Services believes in providing full support for our injured workers, whether they have injured themselves at work or externally we believe that early intervention is the key for an appropriately timed return to pre-injury duties.

This letter is for you, the worker and MPE Services to better understand the workers limitations, our employee operates as a Service Technician performing tasks in the field, we understand that some injuries require the worker to be based in the office for a certain period; however some injuries will only require some restrictions to field based duties.

Below is a list of all tasks specific to the technician, please tick the tasks you believe are not going to pose a risk. It is always preferred, where possible to keep the technician in the field however we require your medical opinion to assist Hastie in preparing a Return to Work Plan.

Technicians Name ______

Office Based Duties / Field Based duties
Answering telephones / Air Conditioning Service & Maintenance Tasks
Filing / Electrical maintenance & Breakdown Work
Administration duties / Manual handle and erecting of A-Frame ladder
Training and Supervision / Manual handle and erecting of an extension ladder
Technical phone service / Occasional Use of Ladders, stairs and steps
Other / Lifting/carrying/manoeuvring equipment >______kgs
Basic Warehouse duties / Gaining access through manhole & working in small spaces
Courier Service i.e. parts delivery / Access points with steps i.e. tall buildings limited lift access
Where available a second person can be assigned to our employee to assist with the above tasks
The technician always has the right to refuse a job if they feel it may put their health or safety at risk
Dr. Name ______
Signature ______Date ______

Thank you for assistance

Anthony Johnson

Service manager

MPE SERVICES