Neonatal Care Leave return to work checklist form template
A supportive return-to-work form for employees coming back from neonatal care leave, ensuring a smooth transition with wellbeing, flexibility, and reintegration in mind.
- 1 page / 203 words.
- Last updated 15/05/2025.
- 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.
Neonatal Care Leave return to work checklist form
Employee Name: ______________________________
Job Title: ____________________________________
Department: _________________________________
Manager: ____________________________________
Date of Return: _______________________________
Section 1: Confirmation of Return
? Return date confirmed and recorded in HR system
? Line manager notified
? Payroll notified (if applicable)
Section 2: Wellbeing Check
? Informal check-in held with employee
? Opportunity given to discuss emotional wellbeing
? Employee signposted to internal or external support services
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This return-to-work form is designed for use after an employee returns from Neonatal Care Leave.
It helps line managers and HR teams support employees by reviewing wellbeing, exploring any flexible working needs, and ensuring that adjustments are made sensitively and appropriately.
The checklist includes confirmation of key return dates, optional reintegration plans, and a forward-looking conversation to ensure the employee feels valued and supported.
Flowchart
Flowchart
Check which resources should be implemeted before and/or after the Neonatal Care Leave return to work checklist form template, to understand the workflow.
Neonatal Care Leave request acknowledgement letter
A clear letter template for acknowledging employee requests for Neonatal Care Leave and outlining next steps, pay eligibility, and available support.
Timings
Timings
Follow these best practice actions to get the most from the Neonatal Care Leave return to work checklist form template, guiding you before, during, and after implementation:
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| Step | Description | Responsibility | Timing |
| 1 | Arrange a return-to-work meeting with the employee to discuss their return, any adjustments needed, and update them on any team or business changes. | Line Manager / HR | 1–2 weeks before return date |
| 2 | Complete the Neonatal Care Leave Return to Work Checklist Form during the meeting, covering wellbeing, workload, any ongoing flexibility needs, and reintegration support. | Line Manager | On day of return or first working day back |
| 3 | Discuss and document any reasonable adjustments, phased return options, or continued support required (e.g. wellbeing resources or hybrid working). | Line Manager / HR | During the return meeting |
| 4 | Share a signed copy of the completed checklist with the employee and HR, and securely store for records. | Line Manager | Within 2 working days after the meeting |
| 5 | Schedule a follow-up check-in to monitor wellbeing and support reintegration into the role. | Line Manager | Within 2–4 weeks after return |
Frequently Asked Questions
Frequently Asked Questions
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Can I use this template in my small business?
Yes. The Neonatal Care Leave return to work 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.
