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Return To Work Interview Form
"I need a Return to Work Interview Form for a manufacturing company employee returning from a physical injury, with specific focus on graduated return arrangements and workplace safety measures for operating machinery, including clear sections for risk assessment and medical certifications."
1. Employee Information: Basic details including employee name, position, department, and manager
2. Absence Details: Information about the period of absence, including start and end dates, reason for absence, and whether it was work-related
3. Medical Certification: Details of medical certificates provided and any medical restrictions or recommendations
4. Current Health Status: Employee's current state of health and ability to perform regular duties
5. Return to Work Arrangements: Specific details about the return to work plan, including date, hours, and any phased return schedule
6. Risk Assessment: Assessment of any risks associated with the return to work and required control measures
7. Support Measures: Agreed support or adjustments to facilitate the return to work
8. Follow-up Plan: Schedule of review meetings and monitoring arrangements
9. Declaration: Signatures from employee, manager, and other relevant parties confirming agreement to the return arrangements
1. Workplace Modifications: Detailed section for cases requiring physical workplace adjustments or equipment modifications
2. Ongoing Medical Requirements: Section for documenting continuing medical appointments or treatments during work hours
3. Performance Adjustment Plan: Used when temporary modifications to performance expectations are needed
4. Psychological Support Plan: Additional section for cases involving mental health or stress-related absences
5. Incident Investigation Reference: Required when the absence was due to a workplace incident or injury
6. Workers Compensation Details: Include when the absence is related to a workers compensation claim
1. Medical Clearance Certificate: Attached medical documentation clearing the employee for return to work
2. Graduated Return to Work Schedule: Detailed weekly plan for phased return to full duties
3. Workplace Adjustment Checklist: List of required modifications to workplace or equipment
4. Risk Assessment Form: Detailed workplace risk assessment related to the return to work
5. Support Services Information: Contact details and information for relevant support services (e.g., EAP)
Authors
Healthcare
Manufacturing
Construction
Mining
Education
Retail
Professional Services
Government
Transport and Logistics
Hospitality
Agriculture
Financial Services
Technology
Telecommunications
Human Resources
Health and Safety
People and Culture
Risk Management
Employee Relations
Occupational Health
Workers Compensation
Operations Management
Human Resources Manager
Health and Safety Manager
Return to Work Coordinator
HR Business Partner
Occupational Health and Safety Officer
Line Manager
Department Supervisor
People and Culture Manager
Workers Compensation Coordinator
Employee Relations Manager
HR Administrator
Workplace Health and Safety Officer
Risk Management Officer
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