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Medical Clearance Form To Return To Work Template for England and Wales

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Key Requirements PROMPT example:

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."

Document background
The Medical Clearance Form To Return To Work is essential documentation required when employees resume work following significant medical absence, injury, or illness in England and Wales. This document ensures compliance with UK workplace safety regulations, protects both employer and employee interests, and maintains proper medical documentation. It includes medical professional assessments, details any required workplace adjustments, and ensures compliance with data protection requirements for handling sensitive medical information. The form is particularly crucial for maintaining occupational health standards and fulfilling duty of care obligations under English and Welsh law.
Suggested Sections

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

Optional Sections

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

Suggested Schedules

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

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓÆµ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions






















Clauses




















Industries

Health and Safety at Work etc. Act 1974: Primary legislation establishing employer duties for employee health, safety, and welfare, including requirements for risk assessment and management in the workplace

Equality Act 2010: Legislation protecting against disability discrimination, requiring reasonable adjustments, ensuring medical information confidentiality, and protecting against discrimination based on health conditions

Data Protection Act 2018 and UK GDPR: Regulations governing the processing of medical data as special category data, including confidentiality requirements, data storage and sharing restrictions, and employee consent requirements

Access to Medical Reports Act 1988: Legislation establishing rights regarding medical reports from doctors, including employee consent requirements and right to view reports before employer access

Management of Health and Safety at Work Regulations 1999: Regulations specifying risk assessment requirements and return to work procedures for ensuring workplace safety

Fit Note Regulations: Guidelines governing Statement of Fitness for Work documentation, including provisions for phased returns and workplace adjustments

Employment Rights Act 1996: Legislation protecting employment status and establishing rights during sickness absence

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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