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COVID-19
COVID-19 Call-out Reporting: The purpose of this form is for managers to record employee call-outs. This is not a substitute for following standard plan call-off procedures.
Employee Name
Employee ID Number
Reason for Leave/Out
--Select One--
Childcare issues/school cancelled
Possible COVID exposure
COVID symptoms
Confirmed COVID/being tested/presumptive positive
Personal health concerns
Other
Reason for submitting
Who is filling out this form?
-- Select One --
Manager
Self/Employee
Other
Manager Name
Manager ID Number