For employers

Refer an employee for track 2

Leave the details of your employee, the first day of sickness and any documents you already have. You receive a confirmation by email straight away. We then contact the employee to schedule the intake.

Your details

The contact person at the employer.

Company name*

First name*

Last name*

Email address*

Phone number

Job title

Remember my company details on this computer

Useful if you refer people more often. Employee details are never stored.

Employee details

We contact the employee to schedule the intake.

Employee first name*

Employee last name*

Employee email address*

Employee phone number*

Employee job title*

First day of sickness*

Determines where the employee stands under the Dutch Gatekeeper Act.

Attachments

For example the occupational health assessment, the employability profile (IZP) or the FML. Up to 8 files, 10.0 MB each. PDF, Word or zip.

Choose files

or drag them here

No attachments chosen yet.

Details

Do not include a medical diagnosis. As an employer you may not record or pass one on; functional limitations and capacity are fine.

I hereby refer my employee for a track 2 programme with Care4Careers. I agree to the privacy statement and confirm that I have informed the employee about this referral.

Next steps

If anything is missing we come back to you. If not, we go straight to the employee.
We invite the employee for an intake with a coach.
The track 2 programme has started.

About your documents

Attachments are stored on European servers and are never publicly accessible. Our team opens them through a link that expires. Files are removed after 90 days.