HS&S RTW - Ver 1.0 - Local

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:

Attendance History

• Please include any relevant information: This could be absence summary screen shot from the people portal

  Media

• Points for discussion:

Absence detail

• Absence start date:

  Date

• Absence end date:

  Date

• Reason:

• Notified by whom:

• Was the correct absence reporting process followed?

  Yes

  No

  N/A

Meeting discussion points

• Please use this section to record your discussions in relation to the individuals absence levels and the implications this may have for them.

• Employee comments:

Support / Action

• Is the employee fit to return to work.

  Yes

  No

  N/A

• Detail any agreed supportive actions.

• Engineer

  Sign

• Manager

  Sign

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