Referrals and Guidance

Guidance for completion of Occupational Health referral forms

Paper referral forms will not be accepted by Occupational Health the only exception in this would be external customers.

Referrals must be made through the online system. If you are experiencing any problems which prevent you from using this system please contact Occupational Health on 01253 (9)57950 as we can no longer process emailed forms from this date.

On-Line Referral Form

Please click on this link to access the user guide for the online referral form and then use the links below to log in.

Referrals submitted incorrectly with manager’s name

If you have submitted a management referral via the One HR portal but unfortunately it appears that you have submitted this in your own name (we have found a few people recently have submitted referrals in their own names, despite entering their staff members names), unfortunately, once you have submitted a referral you cannot change it, and we cannot match it, so you will need to submit another referral.

It appears Microsoft Edge is auto filling these fields and have therefore attached a document our IT department have produced on how to turn off the auto complete feature.

How to Disable Autocomplete in Microsoft Edge

* Please ensure that you select the correct HR email address in the Assigned HR User box so that HR receives a copy of every referral *

HR email for all referrals - please click Login if you already have a username and password, or click New User if you need to register.

General Points

  • Please be aware that all staff are allowed to see their Occupational Health Records and including anything that is written by you on the referral form.
  • Good practice dictates that you should show the completed referral form to the member of staff before you refer them so that they can see what you have said (ideally completing the form together where possible). You must be prepared to justify anything that you state on the referral form.
  • Occupational Health will not accept referrals unless in writing, except in cases of extreme emergency and only at the Occupational Health Physician’s discretion.
  • We offer all members of staff copies of the reports at the same time as sending the report to their Manager.

Completion of forms

Note: if you are returning the form via email, please send it to

The reason why all fields are now mandatory is because incomplete forms have caused huge difficulties for our administration staff, when trying to contact referred staff members and trace their records.

  • Please make sure addresses and contact telephone numbers are current and up to date, as many appointments slots go unused due to appointments that have been sent to old, or incorrect addresses. Please remember that Occupational Health has no way of updating its records of current contact details. We rely on you to be diligent in inputting your details accurately.
  • Amending contact details, can be discussed with a OH staff member when you are discussing referrals with them.

With regards to the specific questions on the form, this is discussed below. The more detail of the situation/staff member you can give, the more we are able to offer focused services, directed specific to the individual's need.

Specific Questions on the form

1. Has there been a previous referral?

This is a tick box question

2. Please provide a background history of this referral

If there has been a previous referral, please give us as much detail as possible.

3. Work/Activities with Role

This is a tick box question

4. Advice or Guidance Required

This is a tick box question

5. Background information

This is particularly important, especially if there are concerns around conduct and disciplinary procedures where the referral may be part of that process. If you haven’t written anything in this section, then we have nothing to take from the staff member's version/perception of events. Our team doesn't take sides, but we rely on information from both parties to allow a complete picture of the scenario to be built. If we have nothing from you, then we will only hear one side and you may feel that your legitimate concerns have not been taken into account.

6. Details of sickness absence.

The relevant dates and reasons for sickness absence must be listed if possible for the last rolling 12 months.

7. What stage of the sickness policy is your employee currently being reviewed?

This is a tick box question.

Make sure you discuss the referral with your employee, and explain the reasons for the referral to Occupational Health.

Please ensure that you sign and date the form, including your correct title. Please include a contact number and the address or email address of where you would like the report sending.

Questions, comments and suggestions

If you have any questions with regard to completion of the forms then please telephone ext 57950 (option 2) and ask to speak to the duty nurse who can guide you through the form.

If you have any comments or suggestions as to how the forms or this guidance can be improved please feel free to contact Joe Ratcliffe on extension 57958.

Useful Documents & Links