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Doctor's Certificate Return To Work
"I need a Doctor's Certificate Return To Work for an employee returning from long-term stress leave, requiring a phased return over 6 weeks starting March 1, 2025, with specific workplace adjustments including reduced hours and quiet workspace requirements."
1. Patient Information: Basic details including name, date of birth, NHS number, contact information and employment details
2. Medical Practitioner Details: Doctor's name, qualifications, GMC number, practice details and contact information
3. Fitness Assessment: Clear statement regarding the patient's fitness to return to work, including any relevant medical conditions
4. Return to Work Date: Specific date when the patient is deemed fit to return to work
5. Medical Declaration: Doctor's formal declaration of professional opinion and signature
1. Workplace Adjustments: Specific recommendations for workplace modifications or accommodations required for the employee's safe return to work
2. Phased Return Plan: Detailed schedule and recommendations for gradual return to full duties, including specific hours and responsibilities
3. Follow-up Requirements: Schedule and requirements for any necessary follow-up medical assessments or reviews
4. Work Restrictions: Specific limitations or restrictions on work activities, if applicable
1. Risk Assessment Form: Detailed workplace risk assessment specific to the employee's condition and job role
2. Occupational Health Review: Additional occupational health recommendations and assessments
3. Patient Consent Form: Written consent from the patient for sharing medical information with employer
4. Medical History Summary: Relevant medical history and treatment details related to the absence from work
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