Absence Form
Employee Name:
*
First Name
Last Name
Employee Email:
*
example@example.com
Employee Phone Number:
*
-
Area Code
Phone Number
Job Site:
*
Supervisor Name:
*
Type of Absence:
*
Sick
Time off
Vacation
Bereavement
Military
Jury Duty Maternity
Other
If available, I would like to use:
*
Vacation Time
Sick Time
None
Reason for Absence:
*
Time off start date:
*
-
Month
-
Day
Year
Date
Return to work date:
*
-
Month
-
Day
Year
Date
You must submit requests for absences like vacation or other known scheduled absences, other than sick leave, fourteen days prior to the first you day will be absent. scheduled appointments should be submitted within fourteen days, but not less than seven days prior to the necessary time off. All other call outs that do not occur within the timelines indicated above will be handled on a case by case basis and may require documentation by management. Signature:
Doctor excuse note:
Today's Date and Time Stamp
Submit
Should be Empty: