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Managers · Fillable Template
Weekly Employee Check-In Template
A ten-minute weekly conversation, structured so she never has to raise a problem unprompted — and so the plan keeps pace with a condition that changes weekly.
For: Managers & employeesTime: 10 minutes weeklyFormat: Letter · print one per week
How to use this
This is not a performance conversation and should never be recorded as one. Ten minutes, same time each week, camera optional. Its purpose is to move the burden of asking from her to you.
This week
Week of
How this week compared
Days affected
Appointments upcoming
Four questions, every week
01How has this week been compared with last week?
02Is anything we put in place no longer working?
03Is there anything on your plate that should move to someone else?
04What would make next week easier?
Plan check
Current accommodations still appropriate
Workload realistic for next week
Deadlines adjusted where needed
Absence reporting method still working
Appointments protected in the calendar
Anything needing HR input
Actions I will take before next week
If any of these appear, act the same day
She mentions not keeping fluids down · significant weight loss · dizziness or fainting · she is working through episodes rather than resting · she seems hopeless or says she cannot continue. Encourage her to contact her provider immediately, and remove work pressure that day. If she mentions thoughts of self-harm, contact your employee assistance provider and, in the United States, share the 988 Suicide & Crisis Lifeline.
THON Tip
End every check-in the same way: "Nothing here goes in your file, and your job is safe." Repetition is what makes it believable.
Next check-in date & anything to prepare
Part of the THON Employer Toolkit™ · Practical guidance · Last reviewed July 2026 · Next review January 2027
This resource is educational. It is not legal advice and does not replace guidance from qualified employment counsel or a healthcare professional. Employment protections for pregnancy-related conditions vary by jurisdiction; confirm your obligations locally. © 2026 The House of Nirvana · thehouseofnirvana.org · info@thehouseofnirvana.org · You are not alone.