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Return-to-work form

A free form for the short conversation when someone comes back after being off sick: when they were off, who held it, what you agreed, and any health notes kept apart.

Fill it in KivoHR in one click

When to use it

On someone’s first day or two back after sickness. Keep it short and supportive: it is to welcome them back and agree anything that would help, not to question whether they were ill.

The law does not require a return-to-work conversation. Good practice: hold one each time, for everyone, which is how you spot patterns fairly and agree adjustments early.

What the law asks of it

  • A fit note from a doctor or other healthcare professional for sickness of more than seven days in a row. (Statutory Sick Pay (Medical Evidence) Regulations 1985)
  • Reasonable adjustments for a disabled employee, such as a phased return or changed duties. (Equality Act 2010, section 20)
  • Health notes are special category data: keep them apart, seen only by those who need them. (UK GDPR, article 9)

The template

Words in [brackets] are yours to fill in.

Return to work

Name
[name]
First day off
[date]
First day back
[date]
Held on
[date]
Held by
[name]

Outcome

  • Back to normal duties
  • A phased return
  • Adjustments agreed
  • Referred to occupational health

Health notes

For example: no lifting for four weeks. Health detail: only people who can see health details see it.

Notes

Email me the Word file

Handy on a phone: we’ll send the Word file and the PDF to your inbox.

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In KivoHR, this form fills itself

  • When someone is back, their manager is told a return-to-work conversation is due.
  • The days off, the fit note and any phased return are already on the record.
  • Health notes are kept apart, and only people who can see health details see them.

Already use KivoHR? Sign in, go to Absence, open the sickness, and choose Return to work.

Sources

This template is general information, not legal advice. For one person’s situation, ask Acas (0300 123 1100, free) or a solicitor.

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