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Return To Work Release Form
"I need a Return To Work Release Form for an employee returning from long-term sick leave due to a back injury, including provisions for phased return and reduced hours for the first month, with the return date set for March 15, 2025."
1. Employee Information: Basic details of the employee including name, position, and department
2. Return Date: Specification of the intended return to work date
3. Health Declaration: Employee's confirmation of fitness to return to work
4. Workplace Adjustments: Details of any required modifications to working conditions or environment
5. Health and Safety Acknowledgment: Employee's confirmation of understanding workplace safety protocols
1. Medical Clearance: Required when returning from serious illness or injury, includes doctor's certification
2. Phased Return Plan: Detailed schedule of graduated return to full duties
3. COVID-19 Declaration: Specific health declarations related to COVID-19
1. Risk Assessment Form: Detailed workplace risk assessment for returning employee
2. Medical Information Consent Form: GDPR-compliant consent for processing health information
3. Occupational Health Report: If applicable, detailed health recommendations from occupational health
4. Workplace Adjustment Schedule: Detailed list of required workplace modifications and timeline
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