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Employee Information

Absence Details

Medical Certification

Click or drag a file to this area to upload.
Attach any required medical documentation (if applicable)

Workplace Accommodations

Are there any specific work restrictions or accommodations needed?

Employee's Acknowledgment

Clear Signature

This Return to Work Form Template from WPForms is designed to assist employees in returning to work after a period of absence.

It enables employers to gather crucial information about an employee’s absence to help with their return to work process and make their experience as comfortable as possible.

Using the Return to Work Form Template

The form begins with the Employee Information section, where employers can capture vital details such as the employee’s full name, employee ID, department, job title, and contact information, including their phone number and email address.

In the next section, the form directly focuses on the employee’s Absence Details, such as the date of the absence, the reason for the absence (such as illness, injury, or personal leave), the duration of the absence in days, and their return to work date.

This information helps in planning and coordinating work schedules effectively. After which, comes the Medical Certification section that includes fields to enter the name of the doctor, clinic/hospital, and the date of medical clearance, followed by a file upload field to attach any medical documentation (if applicable).

Next up, the Workplace Accommodation section is where employers can show their commitment to providing a safe and comfortable place to work for employees; by asking for any details to help with their return, like adjustments to the workstation, specialized equipment, and any other modifications to support the employee’s needs.

Finally, the form concludes with asking for the Employee’s Acknowledgment. Here employees can provide a signature as a confirmation of their acknowledgment of returning to work, helping employers maintain proper records.

Sign up with WPForms today to utilize this Return to Work form template that takes the stress away for facilitating a comfortable back-to-work experience for employees. Also, get access to additional resources for helping with your employee onboarding, while prioritizing their satisfaction and well-being.