Medical report consent form template
To be completed by the subject of the request and returned to the employer.
5 mins
What is a Medical report consent form?
The purpose of this Medical report consent form template is to provide you with a flexible and customisable document to serve as a robust and effective starting point for you.
By using our Medical report consent form template, you can streamline your process, maintain consistency and accuracy, and save time, and it can be easily adapted to fit your specific scenario.
As part of a regular absence review process, usually for employees on long term sick
The Employer (you) to the Employee
Great Britain & NI (United Kingdom), Worldwide
Medical report consent
A copy of this consent form will be enclosed to the GP along with a letter requesting a report.
CONFIDENTIAL
| GP Name: | |
| Address: |
I consent to my employer, [Company], being given a full medical report by the above GP on the present state of my health. I have been informed of my rights under the Access to Medical Reports Act 1988.
Please tick the appropriate box:
[ ] I wish to see the report before it is sent to my employer.
[ ] I do not wish to see the report before it is sent to my employer.
[ ] I will contact the above GP in order to arrange for my access to the report. I reserve my right to request an amendment, to add my own statement or to withdraw my consent for the report to be sent to my employer at that time.
[ ] I require a copy of the report at the same time or immediately after it is sent to my employer.
[ ] I do not require a copy of the report at the same time or immediately after it is sent to my employer.
| Signed (employee): | |
| Date: | |
| Signed (line manager): | |
| Date: |
Version: [1.0]
Issue date: [date]
Why buy our Medical report consent form template?
- It's easily editable and implementable, saving you time and money
- It's designed by CIPD accedited Chartered HR practitioners with operational experience in this area
- You will maintain compliance with ACAS guidelines, legislation, and industry best practices
- Email notifications for any updates made to this template or its accompanying materials
- 12 months of unrestricted access without any additional costs (any update in that period is free to you)
- A 25% discount on all library, toolkit, and template purchases/renewals
