Return to work
Please complete this form after every sickness absence of half a day or more. 
Email *
Date of first day of absence *
MM
/
DD
/
YYYY
Date of last day of absence *
MM
/
DD
/
YYYY
Numbers of days in total *
Reason for absence *
Did you seek medical advice? *
Have you provided a medical note? *
A copy of your responses will be emailed to .
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