Full Management Wellbeing pack

Menopause wellbeing checklist form

Name: Menopause wellbeing checklist form
Brand: hrtemplates.co.uk
Price: 7 GBP
Availability: InStock

£7

Template words
704

Reading time
10 mins

Our Menopause Wellbeing Checklist Form Template helps support employees by addressing key wellbeing factors and ensuring a supportive, informed workplace environment.

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What is a Menopause wellbeing checklist form?

The purpose of this Menopause wellbeing checklist 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 Menopause wellbeing checklist form, you can streamline your process, maintain consistency and accuracy, and save time, and it can be easily adapted to fit your specific scenario.

In which jurisdictions can this form be used?
Great Britain & NI (United Kingdom), Worldwide

Sequence

Previous step

Guide to supporting Menopause at work

Menopause is a workplace issue, and supporting employees through this transition benefits both individuals and the organisation.

This step

Menopause wellbeing checklist form template

Timings

Step	Description	Responsibility	Timing
1	Identify the need for support through self-disclosure, manager observation, or wellbeing check-ins.	Employee or Line Manager	Ongoing / As soon as concerns arise
2	Arrange a confidential wellbeing meeting to discuss menopause-related concerns and provide the checklist form as a supportive tool.	Line Manager or HR	Within 1 week of identification
3	Complete the checklist form collaboratively during the meeting, exploring symptoms, challenges, and potential workplace adjustments.	Line Manager and Employee	During the scheduled meeting
4	Agree on appropriate next steps or reasonable adjustments (e.g., flexible hours, desk fans, access to support resources).	Line Manager (with HR support)	Within 5 working days of meeting
5	Review and follow up on agreed actions to ensure they are effective and revise as needed.	Line Manager	Initial follow-up at 4 weeks; ongoing as required

Menopause wellbeing checklist

Category	Question	Example Response	Action
General Wellbeing	Do you feel comfortable discussing menopause-related concerns at work?	"I feel comfortable with my manager but not with peers."	[Encourage open conversations and awareness training.]
	Do you have access to information or resources about menopause support?	"Yes, but more targeted resources would be helpful."	[Provide clearer guidance on available support.]
	Are you aware of the workplace policies and adjustments available to you?	"No, I’m unsure what support is offered."	[Share policies and ensure employees understand them.]
Physical Comfort at Work	Do you have access to temperature control options (e.g., desk fan, adjustable air conditioning)?	"Yes, but I’d prefer a more consistent temperature."	[Review temperature control measures and offer desk fans.]
	Is your uniform or dress code comfortable and breathable?	"No, the material is too thick and uncomfortable."	[Consider alternative uniform options or relaxed dress code.]
	Are you able to take breaks when needed to manage symptoms such as hot flushes or fatigue?	"Sometimes, but I feel guilty taking extra breaks."	[Reinforce the importance of wellbeing breaks.]
	Do you have access to a quiet space to rest if necessary?	"No, but I would benefit from a dedicated space."	[Identify and allocate quiet/rest spaces where possible.]
Work Environment and Adjustments	Is your workload manageable given your current energy levels and concentration?	"It varies; some days are overwhelming."	[Review workload and consider adjustments if necessary.]
	Have you considered flexible working arrangements, such as adjusted hours or remote work, if needed?	"Yes, but I’m not sure how to request it."	[Provide clear guidance on requesting flexible work.]
	Are you able to step away from your desk or workstation for short breaks?	"Rarely, as my workload is quite heavy."	[Encourage short, regular breaks to improve wellbeing.]
	Do you have easy access to drinking water and bathroom facilities?	"Yes, but bathroom breaks can be difficult during busy shifts."	[Ensure accessibility and awareness of facilities.]
Cognitive and Emotional Wellbeing	Do you experience memory lapses or difficulty concentrating that impact your work?	"Yes, especially in the afternoons."	[Provide memory aids such as reminders or digital tools.]
	Would adjustments like note-taking tools, reminders, or quiet workspaces help?	"Yes, a structured approach would be useful."	[Offer practical tools to support cognitive wellbeing.]
	Are you feeling supported by your manager and colleagues?	"My manager is supportive, but my team is unaware."	[Raise awareness and encourage team support.]
	Do you feel able to request help when needed?	"Sometimes, but I don’t want to be seen as struggling."	[Normalise seeking support and remove stigma.]
Support and Communication	Have you had a conversation with your manager about any adjustments that could help you?	"No, I’m unsure how to start the conversation."	[Provide guidance on how to initiate conversations.]
	Do you know who to speak to if you need further support (e.g., HR, occupational health)?	"Yes, HR has provided a contact."	[Ensure employees know their support contacts.]
	Would access to an Employee Assistance Programme (EAP) or counselling be beneficial?	"Yes, I think talking to someone would help."	[Promote awareness of available mental health support.]
	Do you feel that menopause is openly acknowledged and supported in the workplace?	"No, I think it’s still a taboo topic."	[Introduce awareness campaigns and manager training.]
Next Steps	Identify any adjustments that would help improve your wellbeing at work.	"Flexible working hours and a cooler workspace."	[Discuss potential changes with manager/HR.]
	Arrange a discussion with your manager or HR to explore support options.	"I will schedule a meeting next week."	[Set up a time for a wellbeing review.]
	Access available workplace resources and external support organisations.	"I need to check what’s available."	[Direct employee to menopause resources and support groups.]
	Continue to check in on your wellbeing and make adjustments as needed.	"I will review my situation monthly."	[Schedule regular check-ins on wellbeing.]

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