Sick Leave Form

Sick Time Request

WorkLand Staffing requires you to submit a timely, completed form for sick leave. Failure to provide a completed and sufficient form can result in a denial of your request.

Requests for sick leave must be fulfilled within fifteen (15) calendar days. 

Complete the form below to submit your sick leave request.  

*Mandatory Fields

Agreement
I understand that this request is subject to approval by WorkLand Staffing’s Payroll Department and that it may take up to two (2) pay periods for sick time benefit hours to be credited. I also understand that if I do not have enough sick time hours, or if I have exhausted the benefit, my request may be denied; this includes any absences lasting three (3) or more consecutive days without prior notice, a doctor’s note, or supervisory approval. Furthermore, I understand that prior notice is required for the process of verification. Therefore, if I have not reported my absence to WorkLand Staffing, prior to my shift, I understand that I am subject to having the requested hours delayed; with excessive absences resulting in possible assignment termination and/or ineligibility for future assignment placements.

Acuerdo

Entiendo que esta solicitud está sujeta a la aprobación del Departamento de Nómina de WorkLand Staffing y que las horas de baja por enfermedad pueden tardar hasta dos (2) períodos de pago en acreditarse. También entiendo que, si no cuento con suficientes horas de baja por enfermedad o si he agotado el beneficio, mi solicitud podría ser denegada; esto incluye cualquier ausencia que dure tres (3) o más días consecutivos sin previo aviso, certificado médico o aprobación del supervisor. Asimismo, entiendo que se requiere un aviso previo para el proceso de verificación. Por lo tanto, si no he informado de mi ausencia a WorkLand Staffing antes de mi turno, entiendo que podría sufrir retrasos en las horas solicitadas; las ausencias excesivas podrían resultar en la rescisión de la asignación y/o la inelegibilidad para futuras asignaciones.

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