Absence report

Who is filling this in? (required)

Your name and relationship to the employee (required)

Employee’s name (required)

Department or team (required)

First day of absence (required)

Last day of absence (required)

Not back yet? Give the last day you expect to be off.

Were these full days?

Type of absence (required)

Anything your manager should know

Optional. You do not need to give medical details.

Did you tell your manager on the day? (required)

Is there anything that would help you return?

For example a change of hours or duties for a while.

Declaration (required)

Signature

Draw your signature, or choose Type instead to type your name.