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124567CURRENT
MANAGEMENT8910NOSTATUS3YESNATURE OF
ILLNESS /
INJURYEDUCATIONAL(Last Name, First Name)BIRTHDATEINJURED/SICK
DURING THE
PAST MONTH? The HIGHEST
EDUCATIONAL
ATTAINMENTFAMILY MEMBERSAGENOMALE
FEMALE
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What is illness?
Illness is a state of poor health or disease affecting the body or mind.
Who is required to file illness?
Employees who are unable to work due to sickness or injury are required to file illness.
How to fill out illness?
Illness can be filled out by providing medical documentation, submitting a sick leave request, and informing the employer.
What is the purpose of illness?
The purpose of illness is to notify employers about the employee's inability to work due to health reasons in order to request sick leave.
What information must be reported on illness?
Information such as the date of illness onset, symptoms, medical diagnosis, and expected duration of absence must be reported on illness.
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