This form is for Non-Union Employees only. If you are covered by a Collective Bargaining Agreement (even if you are not a dues-paying member), please use the standard Illness Tracking Form, found here:
https://www.gtpavilions.org/resources/employee/illness-tracking/

Examples of employees covered by Collective Bargaining Agreements (even if not a dues-paying member): Child Care, Universal Worker, CNA, LPN, RN, Maintenance, Custodian, Launderer, Housekeeper

1. When to Complete This Form

   • Fill out this Illness Tracker as soon as you experience any symptoms, even if you are not scheduled to work.
   • Continue filling out the form daily until your symptoms have resolved.

2. Call In Procedure

   • If you need to call in sick for a scheduled shift, notify your supervisor directly.

3. Work Clearance

   • Do not assume you are cleared to return to work unless you have received explicit confirmation from Infection Control.
   • If you have not received an email from Infection Control, contact your supervisor for further guidance and to confirm whether you are able to work.

4. Infection Control Instructions

   • Infection Control will email you specific instructions.
   • You are required to follow any guidance provided until advised otherwise.

5. Earned Sick Time (ESTA) Election

   • This form also serves as your opportunity to elect the use of your accrued Sick Leave under the Earned Sick Time Act (ESTA).
   • If you wish to use your accrued Sick Leave for this absence, please indicate your choice in the relevant section below and specify the number of hours (minimum 1 hour).

Please read all instructions carefully and complete each field accurately. If you have questions about your illness, returning to work, or using Sick Leave, contact your supervisor or Infection Control for assistance.