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Medical Clearance Form To Return To Work
"I need a Medical Clearance Form To Return To Work for an employee returning from long-term stress leave in March 2025, with provisions for a phased return and reduced working hours for the first month."
1. Employee Information: Basic details including name, position, department, and employee ID
2. Absence Information: Details of absence period and reason for absence
3. Medical Assessment: Healthcare provider's evaluation of fitness to return to work
4. Work Capacity Statement: Clear statement of ability to return to normal duties or restrictions
5. Data Protection Notice: Statement about how medical information will be processed and stored
6. Consent Section: Employee's consent for information sharing and processing
1. Workplace Adjustments: Details of any required modifications to duties or environment - use when employee requires temporary or permanent adjustments
2. Phased Return Plan: Schedule for gradual return to full duties - use when employee needs graduated return to work
3. Follow-up Requirements: Schedule for review appointments or assessments - use when ongoing medical monitoring is needed
1. Risk Assessment Form: Detailed assessment of workplace risks relative to medical condition
2. GP/Specialist Reports: Additional medical documentation supporting return to work
3. Workplace Adjustment Plan: Detailed plan of modifications to workplace or duties
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