Sick Leave Notification

Sick Leave Notification

Employee to complete and submit this form to notify the payroll officer of your absence.
Has your manager/supervisor been notified about your absence? If no, please notify your manager/supervisor before submitting form.*

YesNo
Full name*

First NameLast Name
Email
example@example.com
Workplace*
Type of leave*
*Compassionate leave can be taken in a continuous period of 2 days or in 2 separate periods of one day each. This leave is reserved for times when a member of your immediate family or household suffers a life-threatening illness or injury or after the death of an immediate family or household member (inc. miscarriage)
Reason you are unfit to work*
Start of leave*

DayMonthYear
(Inclusive)
End of leave*

DayMonthYear
(Inclusive)
Total number of leave days (DO not include your RDO's just the number of leave days you are claiming)*
(excluding rostered days off and public holidays)
Medical certificate required for any sick leave. Please upload document below.

Cancelof
Signature*

Clear
Date*

MonthDayYear
Should be Empty: