Template

Return to Work Form Template

2,000+

This return to work form can be used by an employee coming from prolonged absence (e.g. due to injury or sickness) to list days of absence and its cause. It also helps collect vital information on how the employee can be reintegrated back into the workforce as quickly and safely as possible.

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Help your team complete tasks more accurately with digital templates that minimize errors from manual processes.

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Generate inspection reports and share them with your team and stakeholders to keep everyone informed.

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SafetyCulture

Free 1,000+ Workplace Checklists & Templates created by the SafetyCulture team.

Template
Return to Work Form Template
Use this employee return to work form to document absence dates and reasons, confirm notification procedures, review previous sickness records, and plan a safe reintegration. Sections include employee and manager details, dates of absence and return, reason for absence, contact and reporting compliance, prior absences in the last 6 and 12 months, and an action plan outlining agreed adjustments, review dates, and comments. The form concludes with employee and manager signatures to confirm understanding and next steps. Intended as a general example; verify suitability for your workplace and jurisdiction.
by Kim Gaston, from the Community
Downloads: 10+
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Template
Return to Work Interview Form
This return to work interview template guides managers and employees through post-absence discussions after sickness or injury. Capture absence dates, reasons, notification details, previous absences, and awareness of procedures. Agree on adjustments and a reintegration action plan, then record signatures from both parties. Use it to standardize HR compliance and support a safe, timely return to work.
by Iain MacPherson, from the Community
Downloads: 10+
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Template
Return to Work Form BCS
This Return to Work form helps managers document employee sickness absence and the steps taken before returning. Capture dates of absence, reasons, medical attention, and any links to previous incidents. Verify compliance with reporting procedures, note accident at work details, and track certificates for absences over seven days. Includes health screening questions, declarations, and signatures for both employee and manager. Built by Bulloughs Cleaning Services and suitable for cleaning operations, yet adaptable across industries.
by Sally Taylor, from the Community
Downloads: 10+
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Template
Return to Work Plan Template
This Return to Work Plan template can be used, particularly by Australia-based employees, to develop a recovery and return to work strategy if they are likely to be away from work for more than four weeks. The return to work plan aims to include the necessary steps required to achieve the objectives agreed on by the employee and the manager.
by SafetyCulture
Downloads: 100+
Get

Return to Work Form Template

Use this employee return to work form to document absence dates and reasons, confirm notification procedures, review previous sickness records, and plan a safe reintegration. Sections include employee and manager details, dates of absence and return, reason for absence, contact and reporting compliance, prior absences in the last 6 and 12 months, and an action plan outlining agreed adjustments, review dates, and comments. The form concludes with employee and manager signatures to confirm understanding and next steps. Intended as a general example; verify suitability for your workplace and jurisdiction.

by Kim Gaston, from the Community

10+

Get

Template

Return to Work Interview Form

This return to work interview template guides managers and employees through post-absence discussions after sickness or injury. Capture absence dates, reasons, notification details, previous absences, and awareness of procedures. Agree on adjustments and a reintegration action plan, then record signatures from both parties. Use it to standardize HR compliance and support a safe, timely return to work.

by Iain MacPherson, from the Community

10+

Get

Template

Return to Work Form BCS

This Return to Work form helps managers document employee sickness absence and the steps taken before returning. Capture dates of absence, reasons, medical attention, and any links to previous incidents. Verify compliance with reporting procedures, note accident at work details, and track certificates for absences over seven days. Includes health screening questions, declarations, and signatures for both employee and manager. Built by Bulloughs Cleaning Services and suitable for cleaning operations, yet adaptable across industries.

by Sally Taylor, from the Community

10+

Get

Template

Return to Work Plan Template

This Return to Work Plan template can be used, particularly by Australia-based employees, to develop a recovery and return to work strategy if they are likely to be away from work for more than four weeks. The return to work plan aims to include the necessary steps required to achieve the objectives agreed on by the employee and the manager.

by SafetyCulture

100+

Get

Return to Work Form Template

With SafetyCulture you can

Digitize team workflows

Reduce manual errors

Create and share inspection reports

About author

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Return to Work Form Template

Return to Work Interview Form

Return to Work Form BCS

Return to Work Plan Template

You might also like

Return to Work Form Template

Return to Work Interview Form

Return to Work Form BCS

Return to Work Plan Template