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The Allied Health Professions Advisory Fitness for Work Report and how to complete it

Allied Health Professional (AHP) Health and Work Report

7. Example condition: Anxiety and depression

Deepak Prasad is a university lecturer. He works full time, teaching and supervising students and undertaking research. He has been off work due to depression for three months and is worried about work and his sickness record. He finds it difficult to concentrate and make decisions. He feels embarrassed about his illness, and facing a group of students. He is worried about his full email inbox.

He has just increased his anti-depressant medication which has initially worsened his early morning symptoms. You are planning to see him once a week for a period of six weeks (Weds mornings 10-11) from today. He has a ‘not fit’ fit note which expires on 14th June. If his manager agrees, he could start a phased return to work before the end of the academic year, initially 3 days a week, 11-4, to gradually pick up his existing/familiar research work over the summer break, with limited teaching duties from September (e.g. 3 hours per week initially).

He may need some support with allocated parking as parking spaces tend to be filled early in the day. It would be best if these teaching duties are on a topic/student group that he feels most confident/comfortable with. You will review his return to work progress with him on 1st August and estimate that he will have returned to full hours and duties by mid November.

Would you like to have a go? - Please fill in the AHP Report.

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Allied Health Professions
Advisory Fitness for Work Report

1 Patient's name: Deepak Prasad
Date of birth: 09/03/1981

I advise that:


2 This form has been completed by a:
Physiotherapist / Occupational Therapist / Podiatrist / Other

Practitioner's name: Your Name
HCPC registration number: OT XXXXX
Organisation/Service: Name of your service / department / unit
Contact details (email/ tel no.): Your contact info
4 AHP Advisory Fitness for Work Report issued for period from to
A follow up review / required* has been made for *delete as appropriate

5 With your employer's agreement you may benefit from these or more options:

Examples of phased returns
Workplace assessments

6 Patient-reported work-relevant difficulty, recommendations and goals:

Difficulty Functional limitations Recommendations / goals Examples of workplace adaptations Examples of workplace adaptations

7 Comments Impact of ongoing clinical management

8 Additional information is provided on 0 accompanying sheets
9 Signature: Your signature

AHPs: please follow the guidance held on the website of your professional body when filling out this form and always attach the information sheet for employees, employers and doctors. Employees, employers and doctors: please read information attached or log on to:

This report does not replace the Statement of Fitness for Work (fit note) for benefits purposes.

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