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Get Return To Work Form

EMPLOYEE The reason for my absence from duty was as follows and I consider that I am now fit to return. TO BE COMPLETED BY INTERVIEWING MANAGER Summary of key points of discussion Absence Summary: .hours/days lost over .occasions in last 6 months ACTION AGREED Please detail any action agreed, including any acceptable attendance levels, support arrangements, occupational health referral etc. Signed (Employee): Date: Signed (Manager): Date:.

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