Colin Meadowcroft

Return to Work Interview

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Title Page

Employee Name
Job title
Conducted on
Prepared by

Interview type
First date of absence
Last date of absence
Length of absence
Reason for absence
Were you on standby during your absence
Did you arrange standby cover
Did you notify your manager
Did you consult your GP
Were you prescribed any medication
Did you receive a fit note
Were there any recommendations on the fit note
Was your absence related to any work factors
Is there anything related to your sickness you wish to discuss
Is there any way the company can assist your return to work
Previous absences for calendar year
Managers comments / recommendations
Signed by Employee
Signed by Manager

Colin Meadowcroft

Return to Work Interview

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.