Template

Return to Work Form

by Agnes Schooling, from the Community

10+

Use this return to work form to conduct effective interviews after an employee absence. Confirm reasons for absence, assess fitness to return, plan phased schedules if required, and capture agreed actions and timelines. Record sensitive information appropriately, note any GP fit notes, and route the completed form to HR for logging. Suitable for HR teams and people managers across industries.

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Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

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+
Get
Template
COVID-19 Return to Work Record
Use this COVID-19 Return to Work Record to document employee details, absence history, and a safe return-to-work induction. Capture symptom checks, confirm PPE issued, brief staff on updated COVID-19 safety measures, and complete manager sign-off for HR compliance. This customizable template supports organizations in standardizing their return-to-work process, maintaining records for audits, and promoting a safe, compliant workplace during reopening and ongoing operations.
by Beth Reed, from the Community
Downloads: 200+
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

COVID-19 Return to Work Record

Use this COVID-19 Return to Work Record to document employee details, absence history, and a safe return-to-work induction. Capture symptom checks, confirm PPE issued, brief staff on updated COVID-19 safety measures, and complete manager sign-off for HR compliance. This customizable template supports organizations in standardizing their return-to-work process, maintaining records for audits, and promoting a safe, compliant workplace during reopening and ongoing operations.

by Beth Reed, from the Community

200+

Get

Return to Work Form

About author

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Return to Work Form Template

Return to Work Interview Form

Return to Work Form BCS

COVID-19 Return to Work Record

You might also like

Return to Work Form Template

Return to Work Interview Form

Return to Work Form BCS

COVID-19 Return to Work Record