Occupational Health Assessment Employee Consent form template
Our Occupational Health Assessment Employee Consent form template streamlines the process, ensuring employee compliance and facilitating efficient health evaluations.
- 2 pages / 330 words.
- Last updated 05/02/2025.
- Designed for United Kingdom use.
- Suitable for use in other territories; check local laws first.
- Instantly download as Word / PDF / plain text, or send by email.
- Includes 12 months’ access, with all updates to this page provided free of charge and notified to you.
Occupational Health Assessment Employee Consent form
I, [Employee's Name], hereby provide my consent to [Company Name] to refer me to Occupational Health for an assessment of my health status and any potential work-related issues. I understand and agree to the following terms and conditions:
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Purpose of Referral: I understand that the purpose of this referral is to assess my health status and any potential work-related issues that may impact my ability to perform my job safely and effectively.
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Confidentiality: I understand that all information gathered during the occupational health assessment will be kept confidential and will only be shared with relevant
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The Occupational Health Assessment Employee Consent form serves as formal authorization from an employee to undergo occupational health assessments. It outlines the employee's agreement to participate in the assessment process, including medical examinations, tests, and consultations, to evaluate their fitness for work or specific job-related tasks.
Additionally, the form seeks the employee's consent to disclose relevant medical information to the occupational health provider for assessment purposes.
The form ensures compliance with data protection regulations by obtaining explicit consent from the employee for the collection, processing, and sharing of their health information for occupational health purposes only. By obtaining informed consent, the employer demonstrates respect for the employee's autonomy and privacy while facilitating access to necessary health assessments to support their well-being and safety in the workplace.
It is usually delivered to the Employer / HR by the Employee.
It should be actioned prior to referring the employee to an occupational health service.
Compliance
Compliance
This Occupational Health Assessment Employee Consent form template incorporates relevant UK laws and HR standards, including those listed below:
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Data Protection Act 2018 (incorporating GDPR): Mandates that employee consent forms comply with data protection regulations, ensuring the lawful processing of personal data.
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Equality Act 2010: Ensures that the assessment process is fair and non-discriminatory, respecting the rights of employees with protected characteristics.
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Health and Safety at Work Act 1974: Requires employers to ensure the health, safety, and welfare of their employees, including facilitating occupational health assessments where necessary.
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Access to Medical Reports Act 1988: Regulates the obtaining and handling of medical reports, including consent requirements and the rights of employees to access and challenge the reports.
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Best Practice: Informed Consent: Ensure that the consent form provides clear information about the purpose, nature, and implications of the assessment, allowing employees to make informed decisions about their participation.
Flowchart
Flowchart
Check which resources should be implemeted before and/or after the Occupational Health Assessment Employee Consent form template, to understand the workflow.
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Our Occupational Health Referral Letter Template facilitates seamless communication with healthcare professionals, expediting employee support and recovery.
Practical example
Practical example
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Scenario: Occupational Health Assessment Employee Consent Form for Long-Term Sick Employee at HealthCare Limited
HealthCare Limited, a healthcare provider, is dedicated to supporting the health and well-being of its employees, including those on long-term sick leave. In line with this commitment, the company implements an Occupational Health Assessment Employee Consent Form to ensure proper assessment and support for employees returning to work after an extended absence.
Context
Jane, an employee at HealthCare Limited, has been on long-term sick leave due to a serious illness. As part of her return-to-work plan, the company schedules an occupational health assessment to evaluate Jane's fitness for work and identify any support or accommodations she may need upon her return.
Implementation
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Sensitive Approach: The HR department approaches Jane with empathy and sensitivity, explaining the purpose and benefits of the occupational health assessment. They assure her that the assessment aims to support her successful return to work and address any health-related concerns.
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Clear Communication: The HR representative provides Jane with clear and concise information about the consent form, explaining its purpose, the types of assessments involved, and the confidentiality of her health information. They address any questions or concerns Jane may have to ensure she fully understands the process.
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Informed Consent: Jane willingly provides her consent to undergo the occupational health assessment, understanding its importance in facilitating her return to work and ensuring her health and safety in the workplace. She signs the consent form, indicating her agreement to participate in the assessment process.
Follow-Up
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Assessment Coordination: The HR department liaises with the occupational health provider to schedule Jane's assessment at a convenient time. They ensure that the assessment is conducted by qualified healthcare professionals experienced in dealing with long-term sick employees.
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Assessment Outcome Review: Following the assessment, the HR representative meets with Jane to discuss the assessment outcomes and recommendations. They provide support and guidance to address any concerns raised during the assessment and collaborate with Jane to develop a tailored return-to-work plan.
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Accommodation Implementation: If the assessment identifies any specific accommodations or support measures needed for Jane's return to work, the HR department ensures their prompt implementation. This may include adjustments to her work environment, modified duties, or access to additional support services.
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Ongoing Support: HealthCare Limited continues to offer ongoing support to Jane as she transitions back to work. The HR department remains accessible to address any further concerns or adjustments needed to support Jane's health and well-being in the workplace.
Frequently Asked Questions
Frequently Asked Questions
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Can I use this template in my small business?
Yes. The Occupational Health Assessment Employee Consent form template is designed to be flexible and suitable for organisations of all sizes, including small businesses and charities. It follows UK employment law best practice, so even if you don't have an in-house HR team, you can confidently apply it.
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Is this template compliant with 2025 UK employment law?
Absolutely. All of our templates are drafted with the latest ACAS guidance and UK employment legislation in mind. We review and update them regularly, so you can be confident they remain compliant.
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Can I customise it for my organisation?
Yes, we highlight the areas that you need to update with your own details, and where you need to make decisions to suit your situation. This saves you time and ensures that you meet best practice.
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Do I get instant access?
Yes. Once purchased, you'll be able to download it instantly. Templates are provided in editable Word or Excel format so you can customise them easily, and in PDF format for easy sharing.
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What if I need more help, not just this template?
If you're looking for broader support, we also offer toolkits and library bundles that include this template, along with other HR templates and policies for fully managing your situation. These may be more cost-effective if you need deeper advice.
