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HUMAN RESOURCES APPLICATION FOR EXTENDED SICK LEAVE Certified Employees Name SS# Address Position Location Is this injury/illness due to a work related injury '? Yes No **Notify Department of Human

How to fill out application for extended sick

How to fill out an application for extended sick leave:

1. Gather necessary information: Before starting the application, make sure you have all the required information handy. This may include your personal details such as name, address, contact information, as well as relevant medical documentation and reports.
2. Contact your employer or HR department: Reach out to your employer or the HR department to inquire about the specific process for requesting extended sick leave. They might provide you with an application form or offer guidance on how to proceed.
3. Obtain the application form: If there is a specific form to be filled out for extended sick leave, request it from your employer or download it from the company's internal portal if available. Take the time to read it thoroughly and understand the provided instructions.
4. Fill in your personal details: Start by filling in your personal information accurately. Make sure to include your full name, employee ID or number, department, and any other required identification details.
5. State the reason for extended sick leave: In a designated section of the application form, clearly state the reason for the extended sick leave. Be concise but thorough, providing necessary details and any supporting medical documentation if required.
6. Indicate the desired duration of leave: Specify the intended duration of your extended sick leave. It is important to be realistic and considerate when indicating the timeframe, as this will help your employer plan and provide necessary support during your absence.
7. Attach any relevant documentation: If there are any medical reports, certificates, or supporting documentation required, ensure you attach them securely to your application. Make sure to make copies for your own records, if necessary.
8. Review and double-check the application: Before submitting the application, take a moment to review all the filled-in information. Double-check for accuracy and completeness, ensuring that you have provided all the necessary details and attached any required documentation.
9. Submit the application: Once you are satisfied with the application form, submit it according to the instructions provided by your employer or HR department. Pay attention to the specified submission method or designated personnel responsible for receiving the application.

Who needs an application for extended sick leave?

1. Employees: Any employee who requires an extended period of sick leave beyond their usual sick leave entitlement may need to fill out an application for extended sick leave. This could include individuals facing severe illnesses, surgeries, or medical treatments that require a longer recovery period.
2. Individuals with chronic conditions: Those suffering from chronic illnesses or conditions that periodically require them to take extended sick leave may also need to complete an application. This helps provide the necessary documentation and justification for their absence from work.
3. Employees with medical emergencies: In the event of unexpected medical emergencies or situations where the employee cannot perform their duties due to health-related issues, an application for extended sick leave may be necessary.

Remember, the specifics of who needs to fill out an application for extended sick leave may vary depending on the company's policies and local labor laws. It is always best to consult your employer or HR department for guidance.

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