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Return to work interview template

Back to work interview form 2026

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The document is a Return to Work Interview form designed for line managers to complete when an employee returns from sickness-related absence. It includes sections for recording the employee's details, absence history, reasons for absence, and any recommendations from healthcare professionals. The form also addresses whether workplace factors contributed to the absence and outlines necessary follow-up actions or support required for the employee's reintegration into work.

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Click ‘Get Form’ to open the back to work interview form in the editor.
Begin with Section 1, filling in your name, business area, job role, line manager's name, and the date of your return to work interview. Ensure you accurately record the dates of absence and reason for absence.
In Section 2, confirm whether the correct sickness procedure was followed and if you consulted your GP. Provide details on any recommendations made by your GP regarding support or adjustments needed for your return.
Continue in Section 3 by indicating if any workplace factors contributed to your absence. Document any agreed actions or additional support required.
Complete Section 4 by confirming if a Self-Certification Form or ‘Fit Note’ has been provided. Sign and date the employee declaration at the end of the form.

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