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Maternity Return To Work Form
"I need a Maternity Return To Work Form for a senior software developer returning from maternity leave in March 2025, including provisions for flexible working and continued breastfeeding arrangements in our open-plan office."
1. Personal Information: Employee details including name, employee number, department, job title and contact information
2. Return Date Information: Confirmation of maternity leave end date and intended return to work date
3. Working Pattern Details: Confirmation of working hours, days and location upon return
4. Health and Safety Declaration: Confirmation of any health and safety considerations or workplace adjustments needed
5. Confirmation and Signatures: Declaration section for employee and manager signatures, including date of completion
1. Flexible Working Request: Section for detailing proposed changes to previous working pattern, including hours, days, or location
2. Breastfeeding Arrangements: Details of required facilities and breaks for nursing mothers returning to work
3. KIT Days Record: Documentation of Keep in Touch days used during maternity leave and any payment due
1. Schedule 1 - Risk Assessment Form: Detailed workplace risk assessment for returning mother
2. Schedule 2 - Flexible Working Application: Formal flexible working request form if changes to working pattern are requested
3. Schedule 3 - Return to Work Checklist: Comprehensive checklist for managers to ensure all return to work requirements are addressed
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