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Request Service
(866) 314-4443
24/7 Emergency Service
Serving Lake, Sumter, Citrus, Marion, Hernando, Levy, and Alachua.
Employee Absence Notification
Employee Name
(Required)
Supervisor Name
(Required)
Employee Email
(Required)
Absence is
(Required)
Approved By Supervisor
Call In
Left Early
Time Out/Time In
Partial Day Only
Reason for Absence
(Required)
Court
Probation
Vacation
Dr Appointment
Jury Duty
Other
If other, please explain
(Required)
Date of Absence
(Required)
Date of Return
(Required)
Reason for Absence
(Required)
All absences, except for sick leave, must be requested two days prior to the first day you will be absent.
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