Guidance Information for the Referring Manager

  1. Guidance Notes on the referral procedure and use of the fitness for work assessment service are available on the Occupational Health Service’s website at If you require further advice on making a referral contact the OH Service , Tel contact 0191 222 7344 or email
  2. The referral must be discussed with the member of staff and his/her agreement obtained before an appointment is arranged. Verbal agreement is sufficient. Signed consent to provide a report to the line manager will be obtained by the OH Physician/Adviser when the member of staff attends the Occupational Health clinic.
  3. This form can be filled in on screen but it must be saved under a new name before printing and emailing this referral request as an attachment to occupational health. 
  4. In section 1.3 please provide sufficient detail on job demands to provide Occupational Health with an overview of the person’s usual work, You must also provide an up-to-date job description for the post. If you have specific concerns over safety, or execution of particular tasks, you should provide detail in Section 1.6
  5. In section 1.5 tick the box to confirm the reason for referral and provide appropriate background information, including information on job performance where this is an issue, and state why a medical opinion is being sought at this time. You should also indicate any specific information you would like to receive in the report.  Note that it is not possible to comment on whether past absences on sickness grounds were justified.
  6. The staff member should be given a copy of the signed referral form for retention and reference.
  7. Once completed, send the form to Occupational Health Services and a copy to you Human Resources team. The OH Clinic will review the detail of this referral and decide on the most appropriate member of the OH team to undertake this assessment – this can be either the OH physician, OH Practitioner/Nurse Advisor, Physiotherapist or Counsellor. The OH Clinic will then contact the member of staff to arrange an appointment. The referring manager will also be notified by email of the appointment date and time.
  8. The referring manager, named HR Manager and member of staff will be sent a copy of all reports by the OH Service subject to the consent given by the employee.

For comprehensive details of the referral process please see the University's Managers Referral Guide [.pdf]