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.
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.
See 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