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2021-2022 Employee Self Report
Please submit the form below for all issues related sick leave including requests for testing.*** You must contact the personnel office to receive permission to return to work.*** Be sure to click the last button and have a copy emailed to your account for your records. Thank you for keeping us informed so that we can help, KT
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Employee Last name *
Employee First name
Please include a phone number and email where you can be reached.
Date of birth.
Nutrition Services and Maintenance/ Transportation : please contact your supervisor.
What is your position in the district?
You are informing CCISD that : Please check all that apply
I would like a free COVID Test. Please have someone contact me to schedule it.
I have been in direct contact with a symptomatic or lab-tested positive individual
I have been lab-tested positive for COVID 19 or have symptoms for COVID 19
My supervisor has directed me to leave my scheduled position due to a COVID 19 related issue
I have traveled out of the country or to a CDC identified hot zone.
Other, please contact Kelly Taylor at
What day were you last at work or near employees/students.
You will be contacted by the personnel office to determine the next steps. You must have the approval to return to work from the personnel office.
In understand I MAY NOT work from home unless I receive written permission from the Personnel Office .
ALL EMPLOYEES: I understand that my supervisor and I must have written permission to return to work from the personnel office.
I understand that documentation for COVID testing, leave and remote work is required.
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Calhoun County ISD.