Employee Sick Time Request Form

The employee MUST complete, sign and submit this ‘Sick Time Off Request’ form in order to be paid for sick leave.

Additionally, YOU MUST CALL YOUR DIRECT SUPERVISOR & YOUR FOOTBRIDGE RECRUITER to provide notice of your time off.

I attest that I used earned sick time for the authorized reason(s) checked below:
Please provide the dates of your time off.
Signature is required.
reCAPTCHA is required.