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Paid Sick Leave Request

Reminders:

* Sick Leave can be taken in 1-hour increments. 

Please submit the Sick Leave Request form within 2 weeks of returning to work.

This will ensure it is processed in your next week's payroll. Sick Leave should not be submitted on your timecard. This is the form that is used in order for Sick Leave to be processed.

Days & Hours Requested

A maximum of 7 days of PSL per form submission. If you have additional days please submit on another form. By submitting this form you do not need to submit these Paid Sick Leave hours on your timecard. Do not submit PSL Hours on your timecard, this form is sufficient.

Date of Leave*
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Date of Leave
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Date of Leave
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Date of Leave
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Date of Leave
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Date of Leave
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Date of Leave
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By submitting this form, you are indicating that the information on this form is accurate to the best of your knowledge.