New-Critical Illness Leave Request Fillable Form, eff. 9-1-23

Critical Illness days are granted on a case-by-case basis and will not be processed until the necessary documentation is received. Examples of critical illness include hospitalization due to an emergent situation, surgeries/ emergency procedures requiring general anesthesia, and not elective and end-of-life care. The Human Resources Department will utilize a criteria to determine the amount of time allowed for each of the examples listed above. Please note that sick days may be utilized as per BOE Policy.

    1. Employee enters the requested days in Absence Management (aka AESOP) as a sick or personal day(s).
    2. Employee completes form and signs.
    3. Employee attaches supporting documentation for the requested leave.
    4. Immediate Supervisor completes and signs.
    5. Once completed, form is sent to Melina Ardizzone, Confidential - Secretary - HR Staff Registrar, or email
    6. If approved, the Human Resources Department will update your attendance record to reflect the day(s) and notify you.


New Critical Illness Leave Request Fillable Form.pdf, 102.6 KB; (Last Modified on September 10, 2023)