First-day certificate – activate the service

Name (nearest manager)

Phone (client)

E-mail (client)

Name (employee)

Social Security number (employee)

Phone (employee)

E-mail (employee)

Enterprise

Cost center

Place Fältet är obligatoriskt.

Would you like contact with rehab coordinators? Yes No

Is there a decision on a First Day Certificate? Yes No

Has the decision been preceded by an investigation? Yes No

Attach the decision to the order.

Attach the decision and investigation to a compressed file in the order.

Message

File upladding

Activate first-day certificates