This form is used to document caregiver absences and track symptoms that may impact work availability. Caregivers should complete this form if they are unable to work a scheduled shift due to illness or other reasons, or if they are experiencing symptoms that may require monitoring before returning to work. Completing this form helps with scheduling adjustments, health precautions, and workplace safety. In addition to submitting this form, caregivers must also notify their supervisor via text as soon as possible.