Morris House Staff Absence Reporting Form
You must complete the form on your first day of unplanned leave. This form will notify the practice management team upon submission. You should ensure you receive a copy of your submission to your email so that you can be sure this has been processed. You must contact your line manager by 12pm on the first day of your absence to ensure you have everything you need and discuss your return to work.
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Email Address *
Name *
First day of absence *
MM
/
DD
/
YYYY
Date of intended return to work
*
MM
/
DD
/
YYYY
This period of absence includes a weekend:
*
Reason for absence
*
Description
Please explain the symptoms you are experiencing or diagnosis; for other forms of leave please describe the circumstances around needing to take unplanned leave.
*
I confirm that I will contact my line manager by 12pm on the first day of my absence.
*
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