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PeraltaCommunityCollegeDistrict HumanResourcesDepartment 333E8thStreetOakland,CA94606MEDICALLEAVEREQUESTFORMEMPLOYEEIDNUMBERLASTNAMEFIRSTNAMEPHONEMIDDLENAMEEMAILCAMPUSManagementDEPARTMENTMANAGERSNAMEPartTimeFaculty/AdjunctFacultyFullTimeFacultyClassifiedReasonforLeaveRequest: IwillsubmitamedicalcertificationfrommydoctortoHumanResourceswithinfive(5)businessdaysofsubmissionofthisfor
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How to fill out leave of absence request

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How to fill out leave of absence request

01
Obtain the leave of absence form from your employer or download it from their website.
02
Fill out your personal information such as your name, employee ID, and contact details.
03
Specify the reason for the leave of absence and the dates you will be absent.
04
If applicable, provide any supporting documentation such as a medical certificate or travel itinerary.
05
Review the form for accuracy and completeness.
06
Submit the completed form to your supervisor or the designated department.
07
Keep a copy of the form for your records.

Who needs leave of absence request?

01
Anyone who requires a temporary break from work typically needs to submit a leave of absence request. This may include employees who are ill, have personal emergencies, or need to take time off for vacation or maternity/paternity leave.
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A leave of absence request is a formal request submitted by an employee to their employer seeking permission to be away from work for a specified period. This could be for personal, medical, or family reasons.
Employees who wish to take time off from work, whether for medical, personal, or other eligible reasons, are required to file a leave of absence request.
To fill out a leave of absence request, employees typically need to complete a designated form provided by their employer, providing details such as the reason for the leave, the start and end dates, and any supporting documentation if required.
The purpose of a leave of absence request is to communicate the employee's intention to take time away from work, allowing the employer to plan for coverage and understand the employee's needs.
The information that must be reported typically includes the employee's name, department, reason for the leave, dates of absence, contact information during the leave, and any relevant documentation.
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