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Sick Leave Reporting: COVID-19 Please complete both sides of this form, if you were absent due to COVID-19 (and be sure to include all verification documents).NOTICE: Under Senate Bill 95, effective
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How to fill out covid-19supplementalleaveform

01
Obtain a copy of the covid-19 supplemental leave form from your employer.
02
Fill out personal details such as name, employee ID, and contact information.
03
Specify the dates you are requesting leave for and the reason for the leave (e.g. covid-19 illness, exposure, caregiving).
04
Provide any supporting documentation or evidence if required.
05
Sign and date the form before submitting it to your employer for approval.

Who needs covid-19supplementalleaveform?

01
Employees who need time off from work due to covid-19 related reasons such as illness, exposure, or caregiving may need to fill out a covid-19 supplemental leave form.
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COVID-19 supplemental leave form is a document used to apply for additional leave due to COVID-19 related reasons.
Employees who need additional leave due to COVID-19 related reasons are required to file this form.
To fill out the COVID-19 supplemental leave form, employees need to provide their personal information, details of their COVID-19 related situation, and any supporting documentation.
The purpose of the COVID-19 supplemental leave form is to request and document additional leave for COVID-19 related reasons.
The COVID-19 supplemental leave form must include personal information, details of the COVID-19 situation, and any supporting documentation.
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