Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Sick Pay Form If you are calling out sick for a scheduled shift for any reason, please complete the information below in full and one of our HR Associates may contact you if we have any questions. Some fields and responses are optional. Name *FirstLastPhone *Mobile phone or best number to reach youEmail *(If you do not have an email address, just put none@none.com)Employee Number *If you are a current employee, please put your employee number. If you do not know it, put UNKPrimary reasons for use of accrued Sick Pay *Absence is related to COVID-19Medical appointment for myselfI am too ill to work - Sore ThroatI am too ill to work - CoughI am too ill to work - Stomach AcheI am too ill to work - AllergiesI am too ill to work - MigraineI am too ill to work - InjuryOther (must include comments in each family field below)(Please check all that apply. Work-related injuries must be called into HR immediately.)File Upload Click or drag a file to this area to upload. Please upload any documents related to test results, if required, or you can email to HR@IslandSocialServices.orgFamily #1 *Name of the child/adult with whom I was scheduled to workMissed Schedule and Comments #1 *MUST list dates and hours scheduled and reason care was cancelled (eg. Monday 1/2/2023 from 5pm-8pm=3 hours. I was too ill to work.) You can put multiple dates/times if that applies.Family #2Name of the child/adult with whom I was scheduled to work Missed Schedule and Comments #2See Comments #1 section above for directions. Please login to Paylocity, our payroll system, to view your current sick pay balance.After completing the CAPTCHA, click SUBMIT SUBMIT