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Return to work interview form template

Reviewed 15 March 2021

Used as part of good absence policy, this form is used to record a brief interview with an employee returning from any period of sick absence to suggest ways in which the employer can help, or if the employee needs any support.

This form should be used to record the Return to Work Interview between the manager and employee. It should be completed by the manager as soon as is practicably possible on the employees first day back at work after illness (in some cases the interview must take place before the employee is allowed back to their usual work location), and signed by both manager and employee.

Return to work interview

Section 1

Employee name:  
Job title:  
Department:  
First day of absence (date):  
Last day of absence (date):  
Date returned to work:  
Total number of days off work:  
Reason for absence(Please give a brief description of the illness or other reason for absence):  
Is absence due to an injury at work? Yes | No

This is a word-limited preview. The full template will be displayed here in full once you purchase it individually, or when you purchase the management template pack.

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Unlimited downloads of this Return to work interview form template, all other Absence templates, AND everything else in the Management template pack for 12 months.

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