Absence & Holiday Form

Holiday & Absence Form

You can use this form to either request holidays OR to be completed before you return to work following a reportable absence.

Type of Request:

Please select if you are completing a holiday request form OR completing an absence form after an unauthorised absence.

Full Name(Required)

Enter your full name including forename and surname.

Email(Required)

You will receive a copy of your completed form.

Area/ Team you work in:

Select the area or team you work in - if you work in more than one team, then select the area you complete your most hours in.

Holiday Date From:(Required)

Please enter the date you are UNAVAILABLE for rotas.

What shift period is your holiday to commence from?

For example If you are available for AM & lunches select from Tea and if unavailable all day select all day.

Holiday Date To:(Required)

Please enter the date you are AVAILABLE again for rotas.

What shift period are you available for rotas?

For example If you can return to work from Tea calls on date holiday ends select here - if you are available all day on the date holiday ends select all day.

Holiday Request Reason:(Required)

What date have you been off from:(Required)

What date are you able to return to work:(Required)

If you have been off work for an extended period of absence 10 days or more and or under medical advice you may require a follow up with your manager or HR before returning.

Reason for absence:(Required)

Do you confirm you are fit to return to work at normal duties?(Required)

If you select no your absence declaration cannot be accepted and you will need to speak to HR.

Yes

Holiday Rules

1. You cannot make holiday requests more than 12 months in advance, these will not be responded to.
2. No holidays will be granted from WC 16/12/2024 - 13/01/2025, this is to manage the Christmas & New Year Period.
3. Please allow up to 2 weeks for a holiday request to be reviewed and granted or declined. If we are unable to grant your request we will inform you why.
4. If after 2 weeks your request has not been responded to please contact your rota co-ordinator for your area.

5. If you have made a holiday request which has been declined, which is then followed up with a sickness or absence this will be addressed.

If you have 3 or more absences within a 3 month period you will require either a "Wellness Check in" or a "HR Check in" dependant on your absences.

If your absences persist following the check-in period your suitability and availability for your care role will have to be reviewed and further action taken.

Holiday & Absence Form

You can use this form to either request holidays OR to be completed before you return to work following a reportable absence.

Type of Request:

Please select if you are completing a holiday request form OR completing an absence form after an unauthorised absence.

Full Name(Required)

Enter your full name including forename and surname.

Email(Required)

You will receive a copy of your completed form.

Area/ Team you work in:

Select the area or team you work in – if you work in more than one team, then select the area you complete your most hours in.

Holiday Date From:(Required)

Please enter the date you are UNAVAILABLE for rotas.

What shift period is your holiday to commence from?

For example If you are available for AM & lunches select from Tea and if unavailable all day select all day.

Holiday Date To:(Required)

Please enter the date you are AVAILABLE again for rotas.

What shift period are you available for rotas?

For example If you can return to work from Tea calls on date holiday ends select here – if you are available all day on the date holiday ends select all day.

Holiday Request Reason:(Required)

What date have you been off from:(Required)

What date are you able to return to work:(Required)

If you have been off work for an extended period of absence 10 days or more and or under medical advice you may require a follow up with your manager or HR before returning.

Reason for absence:(Required)

Do you confirm you are fit to return to work at normal duties?(Required)

If you select no your absence declaration cannot be accepted and you will need to speak to HR.

Yes

Holiday Rules

1. You cannot make holiday requests more than 12 months in advance, these will not be responded to.
2. No holidays will be granted from WC 16/12/2024 – 13/01/2025, this is to manage the Christmas & New Year Period.
3. Please allow up to 2 weeks for a holiday request to be reviewed and granted or declined. If we are unable to grant your request we will inform you why.
4. If after 2 weeks your request has not been responded to please contact your rota co-ordinator for your area.

5. If you have made a holiday request which has been declined, which is then followed up with a sickness or absence this will be addressed.

If you have 3 or more absences within a 3 month period you will require either a “Wellness Check in” or a “HR Check in” dependant on your absences.

If your absences persist following the check-in period your suitability and availability for your care role will have to be reviewed and further action taken.

Call us: 028 43 725 385

Absence & Holiday Form

Holiday & Absence Form

Holiday & Absence Form

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