Confidential to Occupational health. The below form is to be completed by referring Manager.

Notes for the referring manager:

1. OccDoc provides an independent, confidential advisory service to both employees and the employer on all matters relating to the effect of health on work and work on health.
2. The reason for referral must be discussed with the employee in advance of the referral. The manager should sign and indicate that she/he has discussed this referral with the employee being referred.
3. To ensure the occupational health consultation is beneficial for all parties, it is essential that all relevant background information is provided at the time of referral.
4. On completion of the below form, OccDoc will contact the referring manager to arrange an appointment via email. Appointments will only be made on receipt of the completed form. Incomplete forms will be returned to the referring manager.
5. Managers can normally expect a written report following assessment within 1-3 working days of the appointment.
6. The OHD will discuss their findings with the employee which will then form the basis of the report to be submitted on a confidential basis to the referring manager and the employee for successful case management.
7. Please email relevant documentation to admin@yourdoctor.ie