Procedures To Follow When Taking A
Leave of Absence
Leave of Absence
> Notify your Principal or Supervisor
> Submit a letter to the Personnel Office requesting leave
Letter needs to contain the following Information:
- Reason for leave
- Date the leave will start
- Date you plan to return to work
- It the dates change, it is your responsibility to notify the Personnel Office at Central Office and submit a revised letter with the corrected information
- You must state your plan to use sick days and/or personal days or if leave will be unpaid
> Other Documents Needed
- CHCPE- Certification of Health Care Provider for Employee Serious Health Condition
- CHCFM- Certification of Health Care Provider for Family Member Serious Health Condition
- Request for Protected Health Information (HIPPA)
- Request for Family and Medical Leave of Absence (FMLA)
- Maternity/Adoption/Childrearing Leave Request
Call the Payroll Department prior to going on leave to discuss how the leave will
effect your pay or other benefits.
> Leave Extended
If your medical leave is extended, it is your responsibility to submit a Physician's
statement and complete the necessary documents to extend your leave.
> Return to Work
Physician's statement of release must be submitted prior to returning to work
for all employees on leave.
The Physical Performance Requirements for Return to Work form is required for
the following positions:
for all employees on leave.
The Physical Performance Requirements for Return to Work form is required for
the following positions:
- Maintenance Worker, Custodian, Cook
- Instructional Assistant, Childcare Worker, Lunchroom Monitor, Bus Monitor