CCISD COVID 19: Self-Report and Test Request
Please submit the form below for all issues related sick leave including requests for testing. This means you are unable to work in your assigned location and need leave or permission to work remotely. *** 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.
Email *
Employee Last Name *
Employee First name *
Location *
What is your position in the district? *
Please describe your most recent contact with students or staff including dates. *
Date (s) to be absent if applicable.
Total number of days absent can not be determined at this time. You must have the approval to return to work from the personnel office. *
Reason for this submission
Clear selection
Please check all that apply
Reason for absence, testing request or other...
Please include a phone number and email where you can be reached. *
You are requesting to .......
Clear selection
Please check that you have read this leave request and agree by checking the box below. This will serve as your electronic signature. Someone will contact you shortly with a decision regarding leave. You must secure permission to return to work from the personnel office.
A copy of your responses will be emailed to the address you provided.
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