Absence Form
This is also a Self-Certification form for Sickness Absence. This form must be completed by each employee on return to work following any unplanned absence, whether sick or other.
Personal Details
Required for every Absence
Name
First Name
Last Name
1st day of absence
*
-
Day
-
Month
Year
Date
Last day of absence
-
Day
-
Month
Year
Date
Date of return to work
-
Day
-
Month
Year
Date
Total time absent
Total days/hours
Reason for absence
Submit
Should be Empty: