Return to Duty Report Form
Document an employee’s return to work following an absence. Please complete all fields accurately.
Employee Full Name
*
First Name
Last Name
Employee ID
*
Department
*
Please Select
Human Resources
Finance
Operations
IT
Sales
Marketing
Other
Position/Job Title
*
Date of Return
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Absence
*
Please Select
Sick Leave
Personal Leave
Vacation
Parental Leave
Other
Absence Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Absence End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Supervisor/Manager Name
*
Comments or Notes
Submit
Should be Empty: