Return to Work Arrangements Template with Proposed Suitable or Pre-Injury Employment

Return to Work Toolkit
Return to Work
Arrangements Template

Return to Work Arrangements Template
Includes Proposed Suitable or Pre-Injury Employment
Details
These return to work arrangements are for:
Name of worker WorkSafe claim number
Georgia Kelly TBC
Pre-Injury work:
Job title Days/hours of work
Administration assistant 38 hours per week
Location
23 Brunton Avenue, Derrimut, 3030
Name of employer
ABC Logistics
Return to Work Arrangements
Duties or tasks to be undertaken
Describe the specific duties and tasks required. Include any physical and other requirements, e.g. lifting, sitting, rotation
of tasks, etc.
Georgia is entrusted with the responsibility of assisting the administrative staffs in managing the administration.
Specifically, she is to do file work by sitting on the computers for long hours. The data entry work involves sitting and at
other times, she needs to stand for taking notes from the administrative staffs.
Workplace supports, aids or modifications to be provided
Describe workplace supports, aids or modifications, e.g. rest breaks, buddy system, special tools, equipment, training,