Sick Leave Form (pdf)

(AKA "Pink" Sick Leave Form)

The Sick Leave Form is used:

Individual departments may have policies requiring this form be used at other times as well.

The form is retained by the employee's department to document medical verification of sick leave in the above circumstances. However, a copy may need to be sent to the Human Resources Department for the employees personnel service file if:

Last updated Jan 10, 2013

QUICK LINKS

Home

Contact us

Email updates

Find a service

About this site

For employees

Accessibility:
For reasonable accommodations or alternative formats, contact 311.
People who are deaf or hard of hearing can use a relay service to call 311 at 612-673-3000.
TTY users can call 612-673-2157 or 612-673-2626.

Para asistencia 612-673-2700, Yog xav tau kev pab, hu 612-637-2800, Hadii aad Caawimaad u baahantahay 612-673-3500. 

CONNECT

311 call center

TTY relay service

City of Minneapolis Facebook City of Minneapolis Twitter City of Minneapolis YouTube ChaNNEL Minneapolis 311 Minneapolis 14 Government TV City of Minneapolis LinkedIn

Minneapolis, City of Lakes logo