Menopause wellbeing checklist form template


Our Menopause Wellbeing Checklist Form Template helps support employees by addressing key wellbeing factors and ensuring a supportive, informed workplace environment.
- 2 pages / 704 words
- Instantly download as Word / PDF / plain text
- Suitable for worldwide use (but check local legislation)
- Includes 12 months’ access, with all updates to this page provided free of charge and notified to you.
Menopause wellbeing checklist form
Category | Question | Example Response | Action |
General Wellbeing | Do you feel comfortable discussing menopause-related concerns at work? | "I feel comfortable with my manager but not with peers." | [Encourage open conversations and awareness training.] |
Do you have access to information or resources about menopause support? | "Yes, but more targeted resources would be helpful." | [Provide clearer guidance on available support.] | |
Are you aware of the workplace policies and adjustments available to you? | "No, I’m unsure what support is offered." | [Share policies and ensure employees understand them.] | |
Physical Comfort at Work | Do you have access to temperature control options (e.g., desk fan, adjustable air conditioning)? | "Yes, but I’d prefer a more consistent temperature." | [Review temperature control measures and offer desk fans.] |
Is your uniform or dress code comfortable and breathable? | "No, the material is too thick and uncomfortable." | [Consider alternative uniform options or relaxed dress code.] | |
Are you able to take breaks when needed to manage symptoms such as hot flushes or fatigue? | "Sometimes, but I feel guilty taking extra breaks." | [Reinforce the importance of wellbeing breaks.] | |
Do you have access to a quiet space to rest if |
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This Menopause wellbeing checklist form template aims to offer you a versatile and customisable tool, serving as a solid foundation for your needs. Utilise it to ensure consistency, enhance accuracy, and save valuable time.
Adapt it to suit your unique requirements, ensuring efficiency and effectiveness in your HR processes.
Flowchart
Flowchart
Check which resources should be implemeted before and/or after the Menopause wellbeing checklist form template, to understand the workflow.

Managers guide to supporting Menopause at work
Menopause is a workplace issue, and supporting employees through this transition benefits both individuals and the organisation.
Timings
Timings
Follow these best practice actions to get the most from the Menopause wellbeing checklist form template, guiding you before, during, and after implementation:
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Step | Description | Responsibility | Timing |
1 | Identify the need for support through self-disclosure, manager observation, or wellbeing check-ins. | Employee or Line Manager | Ongoing / As soon as concerns arise |
2 | Arrange a confidential wellbeing meeting to discuss menopause-related concerns and provide the checklist form as a supportive tool. | Line Manager or HR | Within 1 week of identification |
3 | Complete the checklist form collaboratively during the meeting, exploring symptoms, challenges, and potential workplace adjustments. | Line Manager and Employee | During the scheduled meeting |
4 | Agree on appropriate next steps or reasonable adjustments (e.g., flexible hours, desk fans, access to support resources). | Line Manager (with HR support) | Within 5 working days of meeting |
5 | Review and follow up on agreed actions to ensure they are effective and revise as needed. | Line Manager | Initial follow-up at 4 weeks; ongoing as required |
Frequently Asked Questions
Frequently Asked Questions
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Can I use this template in my small business?
Yes. The Menopause wellbeing checklist 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.