Common use of REASON FOR REQUEST TO WITHDRAW DAYS FROM SICK BANK Clause in Contracts

REASON FOR REQUEST TO WITHDRAW DAYS FROM SICK BANK. Number of days requesting from the Sick Leave Bank: Reason for requesting Sick Bank days: (check one) ( ) Catastrophic illness of employee*

REASON FOR REQUEST TO WITHDRAW DAYS FROM SICK BANK. Number of days requesting from the Sick Leave Bank: Reason for requesting Sick Bank daysIn your own words, describe the nature of your condition: (check one) ( ) Catastrophic Date you were last actively at work: Date you are expected to return to work: Date illness/injury occurred: Is this injury / illness of employee*work related? [ ] Yes [ ] No