Critical Illness days are granted on a case-by-case basis. The medical section of the form must be filled out by a physician and include their stamp. Submissions without the physician's stamp or doctor's notes attached will not be accepted.

Critical illness shall be defined as: [1] a life-threatening condition because of disease or injury; [2] a medical state in which death is possible or imminent; [3] an admission to a hospital for emergent care of a critical condition; or [4] surgery requiring the administration of anesthesia, as certified by a physician. Please note: Critical Illness leave cannot be used for dental services, elective surgeries/procedures, cosmetic surgeries/procedures, or pre-testing services. Please note that sick days may also be utilized as per BOE Policy.

1. 1. Employee enters the requested days in Absence Management (aka AESOP) as a sick or personal day(s).
   2. Employee completes part I on form and signs
   3. Physician completes part II on form, stamps, and signs
   4. Once completed, form is sent to Melina Ardizzone, Confidential - Secretary - HR Staff Registrar, or email mardizzone@mersnj.us.
   5. If approved, the Human Resources Department will update your attendance record to reflect the day(s) and notify you.