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Return to Work Discussion Form Template

Facilitate Smooth Transitions Back to Work

Planning for an employee's return can be challenging, but a structured discussion can ease the transition. This Return to Work Discussion Form template is designed for HR professionals and managers to ensure clear and productive communication with returning employees. By using this template, you can gather important information, address any concerns, and reinforce workplace policies, all while making the process efficient and compliant. Enhance your communication, improve employee satisfaction, and promote a safe work environment. Try out the live template to get started today!

Employee full name
Job title
Department or team
Work email
Type of absence
Sickness (physical)
Injury
Surgery/procedure
Mental health
COVID-19 or infectious illness
Family/carer leave
Bereavement
Other
Please Specify:
Absence start date
Absence end date
Brief summary of the reason for absence (share only what you are comfortable sharing)
Was the absence work-related?
Yes
No
Are you fit to resume your full duties today?
Yes
No
Not sure
Please describe any limitations, recommendations, or tasks to avoid
Current symptoms or limitations (select all that apply)
Which temporary adjustments would support your return? (select all that apply)
Please Specify:
Target return-to-work date
Preferred return pattern
Full-time normal hours
Phased return
Part-time (temporary)
Remote-first
On-site only
Hybrid
Not ready to return
Does your role involve any safety-critical tasks? (select all that apply)
Do you require an updated risk assessment before resuming these duties?
Yes
No
Manager summary of discussion and agreed actions
Agreed review date
I confirm the information provided is accurate and I agree to the actions listed
Strongly disagree
Disagree
Neither
Agree
Strongly agree
Employee signature (type full name)
Employee signature date
Manager name (as signature)
Manager signature date
Permission to share relevant information with Occupational Health and HR as needed
Yes
No
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Paper art illustration representing a return to work discussion form for FormCreatorAI article

When to use this form

When an employee is coming back after illness, injury, surgery, or extended leave, use this form to guide a focused conversation. It helps HR, managers, and the employee agree on duties, hours, and adjustments before the first shift. If a clinician has provided guidance, you can attach the Medical clearance form. When you need a quick status check before resuming safety-sensitive tasks, the Health screening form can support your decision. This is useful after a broken wrist, migraines, stress leave, or parental leave, and when roles involve manual work or public contact. You capture risks early, document decisions, and set a clear review date, reducing misunderstandings and repeat absence.

Must Ask Return to Work Discussion Questions

  1. What duties can you perform comfortably today, and which tasks might aggravate your condition?

    This separates safe work from risky tasks so you can assign the right duties. If you have baseline details on mobility or pain, the Employee physical examination questionnaire form can inform your decisions.

  2. What medical advice or restrictions should we follow, and for how long?

    Clear limits on lifting, hours, or exposure help you plan accommodations and stay compliant. Timeframes make it easy to schedule reviews and avoid guesswork.

  3. What schedule changes or phased steps would help you transition back safely?

    A simple step-by-step plan reduces overload and supports a steady return. You can map this out with the Phased return to work form to track hours, duties, and review dates.

  4. What workplace adjustments or equipment do you need to work effectively?

    Identifying tools, seating, PPE, or remote options early keeps productivity high. It also documents reasonable adjustments for HR records.

  5. What warning signs should prompt a check-in or pause, and who should you contact?

    Agreeing on triggers like pain spikes, fatigue, or side effects enables quick action and reduces relapse risk. Naming a contact streamlines support and ensures concerns are addressed fast.

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