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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.

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