Document Control
| Field | Value |
|---|---|
| Document Title | Return-to-Work Interview Form |
| Document Owner | Human Resources |
| Version | 1.0 |
| Effective Date | {{effective_date}} |
| Review Cycle | Annual |
| Classification | Internal Use |
Purpose & Scope
Welcome the employee back, confirm fitness to work, capture context of absence and agree any temporary adjustments.
Absence Summary
| Field | Value |
|---|---|
| Employee | {{employee_name}} |
| Absence Dates | {{absence_dates}} |
| Total Days | {{total_days}} |
| Category | {{category}} |
Interview Discussion
- Welcome and check in on wellbeing
- Confirm reason for absence
- Discuss any underlying patterns
- Confirm fitness to return to full duties
- Agree any phased return or adjustments
- Brief on work missed and priorities
Reasonable Adjustments
| Adjustment | Duration | Owner |
|---|---|---|
Bradford Factor Score
Current score: {{bradford_score}}. Trigger status: {{trigger_status}}.
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
Related templates
Office Petty Cash SOP
This SOP outlines the procedures for managing petty cash within the office, ensuring proper record-keeping and accountability.
Leave Application SOP
This SOP outlines the procedure for employees to apply for leave, ensuring a standardized and efficient process.
Customer Letter for Departed Employee
This letter template informs customers about an employee's departure and introduces their new point of contact. This should be used to maintain clear communication and assure customers of continued service.
Acknowledgment of Merchandise Returned for Repair
This template is used by businesses to formally acknowledge the receipt of merchandise returned by a customer for repair services. It confirms the item received, its condition, and outlines the next steps in the repair process.