HS&S ROD South 2

This document is to support the return to work of an individual and should not be shared publicly. This document should only be shared with the employee, Manager, Regional Manager and HR. The disclaimer & confidentiality statement in iAuditor is not valid in the use of this document.

• Engineer name & tech number

• Payroll number:

• Visit Date/Time

  Date
• Location
  Address

• Completed By:

Record of Discussion

Meeting discussion points

• Please use this section to record your discussion

• Engineer

  Sign

• Manager

  Sign

Please email a copy of this document to the employee, Manager and admin.laserfiche@bskyb.com.