Return to Work Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Employee's name *FirstLastEmployee's Email *Job title (best fit) *TeacherTeaching AssistantOffice AdminMSACaretakerWere you or a dependent unwell?MeA dependentA combination of the twoFirst day of absence *DateTimeLast day of absence *DateTimeName of person conducting the meeting *FirstLastTheir email *Date and Time of the meeting *DateTimeWhere was the meeting held?Who was present at the meeting?What was the reason for the absence, and how fully have you recovered since returning to work? *If this absence was due to caring for a dependent, what alternative arrangements (e.g. childcare, family support, contingency plans) could you put in place should a similar situation arise in the future?Were any risk assessments required, reviewed or conducted as a result of this absence? *YESNOPlease provide a copy Drag & Drop Files, Choose Files to Upload Have any absence trigger points been reached? (e.g., 3 absences in 6 months, 10+ days, patterns) *YESNOPlease specify required, reasonable understand Has an Attendance Improvement Plan (AIP) been set recently or is one now being proposed? *YESNOHas the employee been referred to Occupational Health? *YESNOplease provide details or status. *What support has been offered or discussed with the employee (e.g., phased return, reasonable adjustments)? *How did this absence affect the school's ability to run as usual and meet the needs of pupils? *Employee DeclarationI confirm that I was absent from work due to the reasons outlined in this report on the dates specified above.YESNOI understand that knowingly providing false information may result in disciplinary action. *YESNOManager DeclarationI confirm that I have discussed this absence with the employee and that all required documentation has been completed. *YESNOSubmit
