Return to Work Interview Record
Structured return-to-work interview form for any sickness absence. Reduces repeat absences and demonstrates duty of care.
## Return to Work Interview Record
Conduct for ALL absences — including single-day absences. This is the single most effective intervention for reducing sickness absence.
**Employee:** ___ **Manager:** ___ **Date:** ___
**Absence dates:** From ___ To ___ **Reason given:** ___
**Questions to explore:**
1. How are you feeling now?
2. Is the reason for absence work-related in any way?
3. Is there anything we could do to support you better?
4. Are you aware of any further absence likely?
**Referral to Occupational Health:** [ ] Yes [ ] No
**Reasonable adjustments needed:** [ ] Yes (details: ___) [ ] No
**Employee signature:** ___ **Manager signature:** ___
**Bradford Factor trigger points:** Score >100 or 3+ separate absences in rolling 12 months → formal process.
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Added 9 July 2026 · 0 views