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Farm Safety & Emergency Preparedness

Farm Return-to-Work Plan Template

A farm return-to-work plan template for owners and injured workers to set restrictions, light duty tasks, check-ins, and goals as the worker comes back to the farm.

Download free PDF1 page, US Letter, prints clean in black and white

TemplateFarm Safety & Emergency PreparednessFree PDF

Sections on this template

  • Worker and job information
  • Medical restrictions from provider
  • Light duty tasks available
  • Equipment changes needed
  • Schedule and check-ins
  • Communication contacts
  • Training or retraining
  • Progress notes
  • Full duty target and review

How to use this template

Fill in each section, then have the people involved read it. Edit it until it matches how your operation really works.

Where to check the details

This sheet is a general template, so confirm specifics with your own manuals, labels and local rules. For current official guidance, start with U.S. Department of Labor and OSHA.

For more in this area, see the farm safety guides. Between chores, farm.FM has farm humor, including Farm Fresh Eggs Shelf Life Debate Ends When Hen Demands Credit for Today’s Work, and farming farm stories.

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