Skip to content
087 247 2281
[email protected]
Search
Search
Home
About
Services
Stay at work
Return to work
Employer support
Training & events
Blogs & Articles
Home
About
Services
Stay at work
Return to work
Employer support
Training & events
Blogs & Articles
Contact
Please enable JavaScript in your browser to complete this form.
Business Name
Contact Email Address
*
Where did you hear about Connect4Work?
LinkedIn
Twitter
Friend Referral
Network
Business Referral
Name of Referral? (If Possible)
What is the nature of your Business?
How many employees are currently in your organization?
Is your organization located in a single site or are there other sites?
Please list the other locations.
Does your organization have union representation?
What industry do you operate in?
Do you have an active Return to Work strategy?
Yes
No
Is there a specific person who manages Return to Work activities?
Yes
No
Name of Who Manages Return to Work Activities
Do you have an Employee Handbook?
Yes
No
If so, does it include policies or guidelines addressing;
Early Interventions - Stay at Work
Case Management - Return to Work
Remote Working
Mental Health at work
Diversity and Inclusion
Disability
Are there other relevant policies/guidelines in the handbook?
Yes
No
Are there policies that should be included in the handbook that you would like assistance to write?
Yes
No
Please provide further details here
Do you currently offer training on any of the following topics :
Disability Awareness - (Physical or Mental)
Maternity Supports
Stress Management
Resilience - Awareness / Management
How to support a colleague
Would you be interested in discussing these training sessions?
Yes
No
Are there other areas of concern in your organization that you would like to address through the provision of Training/Mentoring/Coaching?
Yes
No
What wellbeing activities do your staff currently avail of?
Which is the most popular? - Why?
Is there provision for the introduction of any new activities in 2021?
Yes
No
Does your organization currently track absenteeism?
Yes
No
If so, how is this recorded?
Has your organization ever implemented Early Intervention or Case Management strategies?
Were these strategies successfully executed?
Yes
No
What could have been done differently?
Are there particular challenges you would like to discuss with Connect4Work?
What are the areas of Service you are most interested in - please tick all that apply?
*
Consultation
Policy writing
Early Intervention (Stay at Work)
Case Management (Return to Work)
Training
Reason for interest of our service(s)
Please provide additional information that may be of relevance, such as what is currently posing challenges for your organization and where you would like assistance from Connect4Work.
What is the main outcome or result you would like to achieve by working with Connect4Work?
What difference do you think this would make for your organization?
What difference do you think this would make to your employees?
Submit
Please ensure Javascript is enabled for purposes of
website accessibility
