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Sick Leave Form

The document is an Employee Sick Leave Form that collects essential information from employees requesting leave. It includes sections for employee details, type of leave, leave dates, and a space for supervisor approval. The form also allows for the attachment of a medical certificate for sick leave requests.

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Debbieray Santos
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49 views1 page

Sick Leave Form

The document is an Employee Sick Leave Form that collects essential information from employees requesting leave. It includes sections for employee details, type of leave, leave dates, and a space for supervisor approval. The form also allows for the attachment of a medical certificate for sick leave requests.

Uploaded by

Debbieray Santos
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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EMPLOYEE SICK LEAVE FORM

Employee Information
 Name: _________________________________________
 Position: ______________________________________
 Department: ___________________________________
 Date Filed: _______________

Type of Leave Requested:


☐ Vacation Leave
☐ Sick Leave
☐ Emergency Leave
☐ Maternity/Paternity Leave
☐ Bereavement Leave
☐ Others: ___________________________

Leave Details
 Date/s of Leave: From ____________ To ____________
 Total Number of Day/s: __________ day(s)
 Reason for Leave:

For Sick Leave:


☐ Medical Certificate Attached
☐ Not Applicable

Employee Signature: ____________________________


Date: _______________

Immediate Supervisor/Department Head


☐ Approved
☐ Disapproved
Remarks (if any): ___________________________________
Signature: ___________________________
Date: _______________

HR Department
☐ Received
☐ Verified
Processed by: _________________________
Date: _______________

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