Document Control
| Field | Value |
|---|---|
| Document Title | Phased Return-to-Work Agreement |
| Document Owner | Human Resources |
| Version | 1.0 |
| Effective Date | {{effective_date}} |
| Review Cycle | Annual |
| Classification | Internal Use |
Purpose & Scope
Support a safe and sustainable return to full duties following extended absence, in line with medical advice and operational needs.
Parties
| Party | Name |
|---|---|
| Employee | {{employee_name}} |
| Line Manager | {{manager_name}} |
| HR Contact | {{hr_contact}} |
| Occupational Health (if applicable) | {{oh_contact}} |
Schedule
| Week | Days/Hours | Duties | Adjustments |
|---|---|---|---|
| Week 1 | |||
| Week 2 | |||
| Week 3 | |||
| Week 4 |
Medical Recommendations
Summarise advice from GP / Occupational Health. Attach Fit Note where applicable.
Review Milestones
Review Workflow
| Stage | Owner | SLA |
|---|---|---|
| Submission | Employee | Day 0 |
| Manager Review | Line Manager | 2 business days |
| HR Review | HR Business Partner | 3 business days |
| Final Decision | Department Head | 5 business days |
| Communication | HR | Within 1 business day of decision |
Notes
Use this space to capture additional context, attachments referenced, or any deviations from standard process. All notes form part of the official record.
Confidentiality & Data Protection
All personal data captured under this document is processed in accordance with {{company_name}}'s Data Protection & Privacy Policy and applicable data-protection legislation (including GDPR/UK GDPR where relevant). Records are retained for {{retention_period}} and accessed only on a need-to-know basis.
Signatures
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