A management referral may be required where a manager or supervisor identifies a possible health issue that is likely to have an ongoing effect on work attendance or performance. Individuals can be referred whilst they are attending work or if they are absent from work.

To make a management referral a referral form should be completed.

Completing the form

The person making the referral should ensure the employee is aware of the referral and the rationale behind it. The referral form should include the concerns raised by management and the advice required. The employee should be directed to the Adept OH Privacy Policy as part of your discussions around the referral content.


Personal information is treated in medical confidence, and will not be shared unless the employee gives consent.

The exception to this is where Occupational Health are given information which is considered to pose a significant risk to health and safety of the individual or others.

Ready to refer?

  • Please fill in as much of the form as you can as this will save time and effort later on
  • Ensure you indicate the reason for your referral
  • Give as much information as possible

The completed form should be password protected and sent in confidence to

The employee will be contacted by Adept OH Ltd and an appointment for consultation arranged as soon as possible.

After the employee has attended their appointment, and with employee consent, the adviser will produce an outcome report for the referring manager in order to address the questions raised in the referral. This feedback will have been discussed with the employee.

The role of the Occupational Health Service is purely advisory, both to manager and employee, and is in no way enforcing or disciplinary.