All Countries
Employment
Return To Work Interview Form

Return To Work Interview Form Template for New Zealand

Create a bespoke document in minutes,  or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Return To Work Interview Form

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Return To Work Interview Form

"I need a Return to Work Interview Form for a manufacturing employee returning from a workplace injury, with specific focus on physical workplace modifications and a graduated return plan starting March 2025, compliant with ACC requirements."

Celebrated by
Collaborations with
Investors
Document background
The Return To Work Interview Form is a essential document used in New Zealand workplaces to manage and document the process of employees returning to work after an absence. It is designed to comply with New Zealand legislation including the Health and Safety at Work Act 2015, Employment Relations Act 2000, and Privacy Act 2020. This document should be completed during a formal meeting between the returning employee and their manager, typically with HR involvement. It captures crucial information about the absence, any ongoing health or safety considerations, required workplace adjustments, and agreed support measures. The form serves multiple purposes: documenting the return process, ensuring appropriate support is in place, meeting legal obligations, and protecting both employer and employee interests through clear documentation of agreements and arrangements.
Suggested Sections

1. Employee Information: Basic details including name, position, department, and manager

2. Absence Details: Information about the period of absence, including start and end dates, and reason for absence

3. Return Status: Whether the return is full or partial, including current work capacity and any restrictions

4. Health and Safety Assessment: Review of any health and safety considerations or workplace adjustments needed

5. Action Plan: Agreed steps and measures to support the return to work, including any modifications to duties

6. Support Requirements: Details of any additional support, training, or resources needed

7. Review Schedule: Planned follow-up dates and monitoring arrangements

8. Declaration: Signatures from both employee and manager confirming agreement to the return plan

Optional Sections

1. Medical Clearance Summary: Summary of medical clearance details - used when returning from medical-related absence

2. Phased Return Schedule: Detailed schedule of graduated return - used when employee requires phased return to full duties

3. Risk Assessment: Specific workplace risks and mitigation measures - used for injury-related returns or when new health considerations exist

4. ACC Requirements: ACC-specific requirements and documentation - used when return involves an ACC claim

5. Training Needs: Assessment of refresher training requirements - used after extended absences

6. Wellbeing Plan: Ongoing wellbeing support plan - used for stress or mental health-related returns

Suggested Schedules

1. Medical Certificate: Copies of relevant medical certificates or fit notes

2. Workplace Modification Plan: Detailed plan of any required workplace or equipment modifications

3. Graduated Return Schedule: Detailed week-by-week schedule for phased return to work

4. Risk Assessment Form: Completed workplace risk assessment documentation

5. Support Services Information: Information about available support services and contact details

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Linkedin in social icon imageX social icon image
alex.den.21@genieai.co
Relevant Industries

Healthcare

Manufacturing

Construction

Professional Services

Retail

Education

Government

Technology

Transportation

Hospitality

Mining

Agriculture

Financial Services

Telecommunications

Energy

Relevant Teams

Human Resources

Health and Safety

People and Culture

Operations

Occupational Health

Employee Relations

Risk Management

Workplace Wellness

Management

Relevant Roles

HR Manager

Health and Safety Manager

Return to Work Coordinator

HR Business Partner

People and Culture Manager

Occupational Health Advisor

Line Manager

Department Manager

Team Leader

Supervisor

HR Director

Wellness Coordinator

Employee Relations Manager

Operations Manager

Risk Management Officer

Industries
Health and Safety at Work Act 2015: Primary legislation governing workplace health and safety in New Zealand, ensuring safe return to work practices and risk management
Employment Relations Act 2000: Establishes the fundamental employment rights and obligations, including the duty of good faith between employer and employee during return to work processes
Privacy Act 2020: Governs the collection, storage, and use of personal information, including medical information collected during the return to work process
Human Rights Act 1993: Prohibits discrimination based on disability or illness, ensuring fair treatment during return to work processes
Accident Compensation Act 2001: Relevant for employees returning from injury, outlining ACC requirements and rehabilitation processes
Holidays Act 2003: Relevant for managing leave entitlements and return to work arrangements after various types of leave
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Back To Work Form

A New Zealand-compliant form documenting an employee's return to work process, including health clearances and workplace adjustment requirements.

find out more

Medical Return To Work Form

A New Zealand-compliant form documenting medical clearance and conditions for an employee's return to work following medical leave.

find out more

Return To Work Letter

A New Zealand-compliant formal letter documenting arrangements for an employee's return to work after extended absence, including terms, conditions, and any necessary modifications.

find out more

Return To Work Medical Certificate

A New Zealand-compliant medical certificate documenting an employee's fitness to return to work, including any necessary workplace modifications or restrictions.

find out more

Return To Work Offer Letter

A New Zealand-compliant formal letter outlining terms and conditions for an employee's return to work following absence, including specific arrangements and accommodations.

find out more

Return To Work Clearance Form

A New Zealand-compliant form documenting medical clearance and conditions for an employee's safe return to work after illness or injury.

find out more

Employee Return To Work Form

A New Zealand-compliant form documenting an employee's return to work arrangements following absence, including medical clearance and workplace safety considerations.

find out more

Return To Work Interview Form

A New Zealand-compliant form documenting the agreed terms and conditions for an employee's return to work following absence, including necessary adjustments and support measures.

find out more

Return To Work Certification Form

A New Zealand-compliant certification form documenting an employee's fitness and conditions for returning to work after illness or injury.

find out more

Medical Leave Return To Work Form

A New Zealand-compliant form documenting an employee's return to work arrangements following medical leave, including medical clearance and workplace modifications.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: https://www.genieai.co/our-research
Oops! Something went wrong while submitting the form.

Genie’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; Genie’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a £1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our Trust Centre for more details and real-time security updates.

Read our Privacy Policy.