www.theivyleagueway.ca

First Name *

Email Address *

Employee Name

Type of Sick Leave Requested* Same Day Sick Leave Short-Term Sick Leave (3–14 days) Long-Term Sick Leave (15+ days)

First Day of Absence*

Expected Return Date*

Reason for Sick Leave*

Medical Documentation* Attached To be provided Not applicable

Attach Medical Document If any

Max number of files : 1
Max File Upload size of each file : 5 MB
Allowed file types : pdf,doc,docx,jpg,jpeg,png

Supervisor Name *

Employee Declaration
I certify that the information provided above is accurate to the best of my knowledge. I understand that sick leave may be subject to company policies and applicable regulations.

Sick Leave Request Form