Call out/ Tardy - Regency Insurance Group

* For any absences, report them at least 2 hours before your shift starts.

*For any tardiness, report it at least 30 minutes before your shift starts. Great news, we are hiring!
Full Name*

First NameLast Name
Department*
Select one:*

Cover DeskRegency
Today's Date*

MonthDayYear
Date
Select one:*

Call OutGoing to be late
Reason for Calling Out
Date(s) I am going to miss
Date expected to return

MonthDayYear
Date
Upload Medical Certificate/Doctors Note box. (Not mandatory)

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Cancelof
Reason For Being late
Time I will be in by

:HourMinutesAM/PM Option
Upload Medical Certificate/Doctors Note box. (Not mandatory)

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Cancelof
Today I can be reached at*
personal email address
Phone Number*

Area CodePhone Number
Should be Empty: