PAID SICK LEAVE REQUEST FORM

Please fill out this form to inform your supervisor of a PAID SICK LEAVE REQUEST.

Keep in mind that PAID SICK LEAVE requests are a request only and there are many factors that could prohibit you from being granted a request.

An employee may use accrued paid sick days beginning on the 90th day of employment.

An employer shall provide paid sick days upon the oral or written request of an employee for themselves or a family member for the diagnosis, care or treatment of an existing health condition or preventive care, or specified purposes for an employee who is a victim of domestic violence, sexual assault, or stalking.

An employer may limit the use of paid sick days to 24 hours or three days in each year of employment