Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Employees Name
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Division/Contract
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Job Title
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Date RTW carried out
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Date Sickness started
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Date returned to work
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No. of days sick
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Reason for absence
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Response and agreed actions (Sickness/Absence to be added to Bradford and reviewed? Sick Note?)
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Please advise pay;
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Is the employee fully recovered, able to perform their duties and undertake hours of work?
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Is this the first occurrence of this type of absence?
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Has the employee sought medical advice?
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Has the employee been given advice/medication which may have an impact on their ability to do their job?
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Employee signature
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Line Managers Signature