The Return To Work Form Template UK is offered in multiple formats, including PDF, Word, and Google Docs, featuring customizable and printable options.
Return To Work Form Template UK Editable – PrintableSample
Return To Work Form Template UK 1. Employee Information 2. Absence Details 3. Fitness to Work Declaration 4. Adjustments Required 5. Medical Professional Confirmation 6. Supervisor Approval 7. Employee Responsibilities 8. Employer Responsibilities 9. Additional Comments 10. Signatures and Agreements 11. Declaration and Signatures
PDF
WORD
Examples
[Employee’s Name]
[Employee’s ID]
[Department]
[Position]
[Contact Number]
[Date]
[Briefly specify the reason for absence, e.g., illness, injury, maternity leave, etc.]
I confirm that I am fit to return to work on the above date and can perform the duties of my role.
[Employee’s Signature]
[Date]
The employer will review the return and may require a discussion regarding any adjustments or support needed.
[Manager’s Name]
[Manager’s Signature]
[Date]
[Any special instructions, recommendations for phased return, or adjustments required based on the absence reason.]
[Employee’s Name]
[Employee’s ID]
[Department]
[Job Title]
[Email Address]
[Date]
[Provide detailed information regarding the reason for absence, e.g., specific illness or situation leading to leave.]
I declare that I am medically cleared to resume my duties and I am competent to perform my job responsibilities.
[Employee’s Signature]
[Date]
Comments from the manager regarding the employee’s return, including any necessary support arrangements.
[Manager’s Name]
[Manager’s Signature]
[Date]
[Outline any necessary actions or adjustments that should be implemented to facilitate the return, such as training, mentorship, or a phased return schedule.]
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