The Statement of Fitness for Work Form is a crucial document in Singapore's workplace health management system. It is required when employees need to document their medical condition and its impact on their ability to work. This form, compliant with Singapore's Employment Act and Ministry of Manpower regulations, provides essential information about an employee's health status, recommended work modifications, and duration of medical leave. It serves multiple purposes: validating sick leave claims, ensuring safe return to work, and documenting any required workplace accommodations. The document is particularly important for workplace injury cases, extended medical leave, and when modified duties are necessary for an employee's return to work.
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Key Requirements PROMPT example:
Statement Of Fitness For Work Form
"Need a Statement of Fitness For Work Form for an employee returning from a long-term illness, requiring modified duties in our manufacturing facility, with specific focus on reduced lifting requirements and shorter working hours starting March 2025."
1. Patient Information: Basic details including name, NRIC/FIN, date of birth, contact information
2. Medical Practitioner Information: Doctor's name, registration number, clinic/hospital details
3. Medical Condition Assessment: Description of medical condition and its impact on work capability
4. Period of Unfitness: Start and end dates of the medical leave period
5. Work Capacity Statement: Clear statement of whether patient is unfit for work or fit for modified duties
6. Authentication: Doctor's signature, clinic stamp, and date of issuance
1. Modified Duties Recommendations: Specific workplace modifications needed when patient can work with adjustments
2. Follow-up Requirements: Details of required follow-up appointments or reviews when ongoing medical supervision is needed
3. Workplace Restrictions: Specific activities or conditions to avoid when specific workplace restrictions apply
1. Medical Test Results: Relevant test results supporting the assessment
2. Treatment Plan: Detailed treatment or rehabilitation plan if applicable
3. Previous Medical History: Relevant medical history affecting current condition
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