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Full Management Absence and attendance pack

Medical report consent form

£7
Word count
Template words
241
Reading time
Reading time
5 mins

To be completed by the subject of the request and returned to the employer.

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What is a Medical report consent form?

The purpose of this Medical report consent form is to provide you with a flexible and customisable document to serve as a robust and effective starting point for you.

By using our Medical report consent form, you can streamline your process, maintain consistency and accuracy, and save time, and it can be easily adapted to fit your specific scenario.

Best practice timescale for this to be issued
When should this form be issued?
As part of a regular absence review process, usually for employees on long term sick
Issued by who, to whom
Who should issue this form, and to whom?
The Employer (you) to the Employee
Applicable legal jurisdictions
In which jurisdictions can this form be used?
Great Britain & NI (United Kingdom), Worldwide

Medical report consent

A copy of this consent form will be enclosed to the GP along with a letter requesting a report.

CONFIDENTIAL

GP Name:  
Address:  

I consent to my employer, [Company], being given a full medical report by the above GP on the present state of my health. I have been informed of my rights under the Access to Medical Reports Act 1988.

Please tick the appropriate box:

[ ] I wish to see the report before it is sent to my employer.

[ ] I do not wish to see the report before it is sent to my employer.

[ ] I will contact the above GP in order to arrange for my access to the report. I reserve my right to request an amendment, to add my own statement or to withdraw my consent for the report to be sent to my employer at that time.

[ ] I require a copy of the report at the same time or immediately after it is sent to my employer.

[ ] I do not require a copy of the report at the same time or immediately after it is sent to my employer.

Signed (employee):  
Date:  
Signed (line manager):  
Date:  

Version: [1.0]

Issue date: [date]

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medical report consent form