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Back To Work Consent Form
"I need a Back to Work Consent Form for our Mumbai office that includes basic COVID safety protocols and is suitable for a standard office environment with 50 employees returning to work in March 2025."
1. Employee Information: Basic details of the employee including name, employee ID, department, and contact information
2. Health Declaration: Statement where employee declares their current health status and absence of COVID-19 symptoms
3. Workplace Safety Protocols: Overview of the safety measures implemented by the organization that the employee must follow
4. Employee Acknowledgments: Employee's confirmation of understanding the risks and safety protocols
5. Consent Declarations: Explicit consent statements regarding health monitoring, protocol adherence, and reporting requirements
6. Reporting Obligations: Employee's responsibilities for reporting health issues or exposure to COVID-19
7. Signature and Date: Space for employee signature, date, and witness signature if required
1. Vaccination Status: Section for declaring vaccination status and uploading certification - include when organization has vaccination requirements
2. Medical History: Section for declaring relevant medical conditions - include for employees in high-risk categories
3. Remote Work Arrangements: Details of hybrid working arrangements - include when organization offers flexible working options
4. Travel Declaration: Recent and planned travel information - include in areas with travel restrictions or monitoring requirements
5. Special Accommodations: Section for requesting specific workplace accommodations - include when dealing with vulnerable employees
1. Schedule A: Safety Protocols: Detailed workplace safety measures including sanitization, social distancing, and mask requirements
2. Schedule B: Health Screening Procedures: Step-by-step procedures for daily health screening and temperature checks
3. Schedule C: Emergency Contact Information: List of emergency contacts including HR personnel and medical facilities
4. Appendix 1: COVID-19 Symptoms Checklist: Comprehensive list of symptoms to monitor and report
5. Appendix 2: Incident Reporting Form: Template for reporting health incidents or protocol violations
Authors
Information Technology
Manufacturing
Healthcare
Education
Financial Services
Retail
Professional Services
Construction
Hospitality
Telecommunications
Pharmaceutical
Automotive
Media and Entertainment
Real Estate
Transportation and Logistics
Human Resources
Legal
Compliance
Health and Safety
Facilities Management
Risk Management
Operations
Administration
Employee Relations
Human Resources Manager
Legal Counsel
Compliance Officer
Health and Safety Officer
Facility Manager
Department Head
Risk Manager
Operations Manager
Employee Relations Manager
Administrative Manager
Office Manager
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