The Hospital Return To Work Form is a crucial document required under German employment and healthcare regulations when employees resume work following medical leave. It serves as an official record ensuring compliance with workplace safety requirements while protecting employee privacy under GDPR. The form is particularly important in healthcare settings where both employee and patient safety are paramount. It includes medical clearance, specific work capabilities, required accommodations, and duration of any restrictions. The document must align with various German regulations including the Bundesurlaubsgesetz, Entgeltfortzahlungsgesetz, and Arbeitsschutzgesetz, while facilitating clear communication between all involved parties.
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1. Employee Information: Basic identification details including name, employee ID, department, and position
2. Absence Information: Details of the period of absence, including start and end dates of sick leave
3. Medical Clearance Statement: Physician's confirmation that the employee is fit to return to work, without disclosing specific medical conditions
4. Return to Work Status: Clear indication of whether return is full or partial, with basic workplace capabilities assessment
5. Work Restrictions: Specific limitations or modifications required for the employee's safe return to work
6. Duration of Modifications: Timeframe for any temporary work restrictions or accommodations
7. Authorization: Signatures section for healthcare provider, employee, and employer representative
1. Gradual Return Plan: Required when implementing a stepped return to work program (Hamburg Model)
2. Special Equipment Requirements: Include when specific workplace adaptations or equipment are needed
3. Follow-up Appointments: Include when ongoing medical monitoring is required
4. BEM Process Reference: Required for employees returning after more than 6 weeks of absence
5. Occupational Health Physician Review: Include when required by specific industry regulations or risk assessment
1. Schedule A - Workplace Capability Assessment: Detailed checklist of physical and cognitive job requirements and employee capabilities
2. Schedule B - Gradual Return Schedule: Detailed weekly plan for stepped return to work, if applicable
3. Appendix 1 - Privacy Notice: Information about the handling of personal health data as per GDPR requirements
4. Appendix 2 - Employee Rights Information: Summary of employee rights during the return to work process
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