Template

Return to Work Risk Assessment Form Template

by lisa kimber, from the Community

10+

Use this return to work risk assessment form to evaluate hazards, existing controls, and required actions when employees—especially those at higher risk—return to the workplace. Capture employee details, describe hazards and who may be harmed, document current measures, and assign actions with owners and due dates. Review assessments regularly to ensure they remain valid and effective. This template is customizable to align with your organization’s policies, health and safety requirements, and local regulations, and supports consistent, documented decision-making during the return-to-work process.

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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 Risk Assessment Form Template
This return to work risk assessment form is intended to be used to list the identified safety implications associated with the return to work process of employees that are high-risk. The risk assessment process should consider the impact of the workplace on the returning employee's ability to work and if there are existing controls to help mitigate the risk to the employee.
by SafetyCulture
Downloads: 100+
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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+
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Template
Return to Work Assessment
Use this return to work assessment template to evaluate an employee's fitness for duty after illness or injury. Document medical notes, medications, proposed hours, permitted tasks, hazards and controls, and required inductions. Capture acknowledgements and signatures, set review dates, and ensure safe, compliant re-entry to the workplace.
by Sharon Chevis, from the Community
Downloads: 0
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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+
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Return to Work Risk Assessment Form Template

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