undefined

Emergency Sick Leave Request Form

You are not keeping well. We understand!

Time to complete

2 minutes

Eligibility

The Emergency Sick Leave Request Form is intended for use by employees who are unable to work due to illness or injury.

undefined

Questions for Emergency Sick Leave Request Form

1.

Name

The answer should be a text input.
2.

How many working days are you applying for sickness leave

The answer should be a text input.
3.

Start Date

The answer should be a date input.
4.

End Date

The answer should be a date input.
5.

Employee ID

The answer should be a text input.
6.

Position

The answer should be a text input.
7.

Department

The answer should be a text input.
8.

Reason for Sickness Leave

The answer should be a text input.
9.

Employee's Signature

The answer should be a signature.
10.

Date Signed

The answer should be a date input.
11.

Approval Status

The answer should be a single choice:
  1. Approved
  2. Disapproved
12.

Supervisor Name

The answer should be a text input.
13.

Supervisor's Signature

The answer should be a signature.
14.

Date Signed

The answer should be a date input.

Similar Ideas

  • Emergency Leave Request Form
  • Emergency Time Off Request Form
  • Emergency Vacation Request Form
  • Emergency Sick Leave Request Form

Here are some FAQs and additional information
on
Emergency Sick Leave Request Form

How many accumulated sick days do I have?

Usually, companies provide around eight (8) sick days per year.

Can I carry over my unused sick days?

No, unused sick days do not carry over to the following year.

Can I cash out my unused sick days?

No, unused sick days cannot be cashed out.

Want to use this template?

Loved by people at home
and at work

undefined
“BlockSurvey is a simple, effective, and scalable tool for creating surveys for leadership and learning assessment. It's one of this year's best buying choices. Each month, it keeps improving and strives to serve its customers needs.”
Nelson Emilio
Personal Branding Strategist
undefined
“I use BlockSurvey to get feedback about all my activities and events. It is really easy to get started and create my first surveys! Then I could see how easy it was to share them. Now I am thinking to use BlockSurvey also within my creative process as an author in order to listen and engage with my audience, knowing that anonymity provides the most sincere and reliable answers.”
Georgina García-Mauriño
Author & Designer
BlockSurvey social proof
G2 Crowd
4.8 Star Rating
BlockSurvey social proof
Dapp.com
Editor's choice
BlockSurvey social proof
Capterra
4.9 Star Rating

What's next? Try out templates like
Emergency Sick Leave Request Form

1000+ Templates, 50+ Categories

Want to create secure online forms and surveys?

Join BlockSurvey.

SHARE