StartHealth · Template version 2026-10-27

Annual occupational-health action-plan preparation

Gather work changes, an existing workplace-assessment reference and employer priorities for joint planning. Preparation aid only, not a legally sufficient action plan or a medical assessment.

Blank company-process preparation template, not an individual employee case form. Do not enter names, diagnoses, medication, absence history or identifiable case details. Use the employer’s approved secure process for real employee cases. This template does not store or submit information. Editorial process aid, not individual medical or legal advice; medical review pending.

Complete blank fields describing company procedures. Use the browser print dialog for A4 paper or PDF. The blank HTML also works offline.

Inputs and assessment reference

Work changes and priorities

Joint discussion and follow-up

Action / agenda preparation

Company-level observation / changeProposed actionResponsible roleReview checkpointConfirm with occupational health

Fictitious example

A fictitious 15-person software team brings delivery pressure and interruptions to the discussion. The employer proposes a prioritisation practice and responsible role. Occupational health separately assesses health significance and the actual plan; completing preparation is not approval.

Questions about the template

Does this replace the statutory action plan?

No. It prepares inputs and proposals, not a legally sufficient plan or medical assessment.

What belongs in the assessment reference?

The existing employer workplace-assessment document reference and date, not employee patient records.

Can preparation repair a missing plan for a closed accounting period?

No. Kela requires a plan valid during the accounting period; it cannot be backdated for a closed period.