Template for employers and employees to use to review and monitor reasonable adjustments for mental health that have been put in place. Free to use.
You can copy and paste the template text into a document.
Template
| Date of review | [Date] |
|---|---|
| Reasonable adjustment for mental health | [Give details of the reasonable adjustment in place] |
| Does the employee or employer want to request any changes to the existing adjustment? | [Yes / No] |
| Changes requested, who by and reason | [Give details of the changes requested] |
| Changes agreed | [Give details of the changes that have been agreed by the employer and employee] |
| Date for next review | [Date] |
Download this template
- Download this template in Microsoft Word format (DOCX, 16KB)
- Download this template in Open Document format (ODT, 7KB)
If you need this template in a different format, email digital@acas.org.uk
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