Virginia Record of Absence - Self-Certification Form

State:
Multi-State
Control #:
US-457EM
Format:
Word; 
Rich Text
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This Employment & Human Resources form covers the needs of employers of all sizes.
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How to fill out Record Of Absence - Self-Certification Form?

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FAQ

It's a form you can ask an employee to complete to prove they were absent from work due to illness. It provides a short-term alternative to a sick note from their doctor. Self-certification is only available if the employee is off for seven days or less.

Self-certification When they return to work, their employer can ask them to confirm they've been off sick. This is called 'self-certification'. The employer and employee will agree on how the employee should do this. They might need to fill in a form or send details of their sick leave by email.

It's a form you can ask an employee to complete to prove they were absent from work due to illness. It provides a short-term alternative to a sick note from their doctor. Self-certification is only available if the employee is off for seven days or less.

You can be dismissed if you have a persistent or long-term illness that makes it impossible for you to do your job. Before taking any action, your employer should: look for ways to support you - for example, considering whether the job itself is making you sick and needs changing.

If you're off work sick for 7 days or less, your employer should not ask for medical evidence that you've been ill. Instead they can ask you to confirm that you've been ill. You can do this by filling in a form yourself when you return to work. This is called self-certification.

If you're off work sick for 7 days or less, your employer should not ask for medical evidence that you've been ill. Instead they can ask you to confirm that you've been ill. You can do this by filling in a form yourself when you return to work. This is called self-certification.

Many employers have their own self-certification forms. If your employer doesn't have its own form your can download this Self Certification Form (PDF). Please print it, fill it in and hand it in to your employer. You do not need to see a Doctor.

Your GP will not be able to send the computer-completed sick note electronically (for example by email) to an employer and it should always be given direct to the patient.

Self certificationSeven days includes days that you wouldn't normally work, such as weekends. The days must be in a row rather than sporadic. If you're off work for less than seven days, it's unlikely your boss will ask you to provide proof that you were ill in the form of a fit note (formerly known as a sick note).

Fit notes and proof of sickness Employees must give their employer a doctor's 'fit note' (sometimes called a 'sick note') if they've been ill for more than 7 days in a row and have taken sick leave. This includes non-working days, such as weekends and bank holidays.

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Virginia Record of Absence - Self-Certification Form