The Return To Work Form From Doctor is a crucial document required under Indonesian labor law when employees resume work following a period of medical leave or absence. This form, mandated by Law No. 13 of 2003 on Manpower and supported by various health and safety regulations, serves as an official medical certification of an employee's fitness to return to their duties. It is designed to protect both employer and employee interests by clearly documenting medical clearance, any necessary workplace accommodations, and specific health-related restrictions. The form includes comprehensive medical assessments and recommendations, ensuring compliance with Indonesian workplace safety standards and healthcare regulations. It is particularly important in cases involving workplace injuries, extended illnesses, or conditions that may affect job performance, and may be required for BPJS healthcare documentation.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Your data doesn't train Genie's AI
You keep IP ownership聽of your docs
1. Employee Information: Basic details including employee name, ID number, position, department, and contact information
2. Medical Assessment Details: Date of examination, reason for leave (illness/injury), period of absence, and treating physician's information
3. Return to Work Status: Clear statement of whether employee is fit to return to work (full duties, modified duties, or not fit)
4. Work Capacity Evaluation: Assessment of employee's current capabilities and limitations in relation to job requirements
5. Medical Recommendations: Specific medical advice regarding work conditions, restrictions, or accommodations required
6. Duration and Follow-up: Timeframe for any restrictions, date for follow-up assessment if needed
1. Rehabilitation Plan: Include when employee requires ongoing rehabilitation or therapy while working
2. Workplace Modifications: Include when specific workplace adjustments or equipment are needed
3. Gradual Return Schedule: Include when employee needs a phased return to full duties
4. Risk Assessment: Include when there are specific workplace risks that need to be addressed due to the employee's condition
5. BPJS Documentation: Include when the medical leave was covered under BPJS insurance and requires specific documentation
1. Physical Capacity Assessment Form: Detailed evaluation of employee's physical capabilities and limitations
2. Medication Schedule: If employee requires ongoing medication during work hours
3. Work Restriction Details: Specific list of restricted activities or environmental conditions to be avoided
4. Follow-up Appointment Schedule: Timeline of required follow-up medical assessments
Find the exact document you need
Employee Back To Work Letter
An Indonesian-law compliant letter formally documenting an employee's return to work terms and conditions after an extended absence.
Download
Return To Work Clearance Letter
An Indonesian regulatory document that provides medical clearance for employees returning to work after absence, complying with Indonesian labor and safety laws.
Download
Return To Work Form From Doctor
An Indonesian-compliant medical certification form documenting an employee's fitness to return to work, completed by a qualified physician in accordance with Indonesian labor laws.
Download
Return To Work Letter From Doctor
An Indonesian-compliant medical certification document authorizing an employee's return to work following medical leave, including any necessary work modifications or restrictions.
Download
Return To Work Letter
An Indonesian-law compliant formal document confirming an employee's return to work terms and conditions after an extended absence.
Download
Medical Certificate For Return To Work
An Indonesian-compliant medical document certifying an employee's fitness to return to work after medical leave, including any necessary workplace modifications or restrictions.
Download
Back To Work Order Letter
An Indonesian law-compliant formal letter instructing employees to return to work, specifying conditions and arrangements for workplace reentry.
Download
Doctors Clearance Letter To Return To Work
An Indonesian-compliant medical certification document authorizing an employee's return to work following medical leave, issued by a licensed healthcare provider.
Download
Medical Return To Work Letter
An Indonesian-compliant medical document certifying an employee's fitness to return to work after medical leave, including any necessary workplace accommodations and conditions.
Download
Intent To Return To Work Letter
An Indonesian-compliant formal letter notifying an employer of an employee's intention to return to work following an extended absence, in accordance with Indonesian labor laws.
Download
骋别苍颈别鈥檚 Security Promise
Genie is the safest place to draft. Here鈥檚 how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; 骋别苍颈别鈥檚 AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it