Employee Call Out Form
Employee Name
*
First Name
Last Name
Date of Absentee
*
-
Month
-
Day
Year
Date
Date Returning to Work
*
-
Month
-
Day
Year
Date
Reason for Absentee
*
Please Select
Sick
Weather Conditions
Family Emergency
Bereavement
Doctors Appointment
Other
If other, please explain:
If you are missing part of a day, please explain:
Submit
Should be Empty: