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Employee Identification No.: ________
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Attention: ________
RE: NOTICE OF SICK LEAVE / MEDICAL LEAVE OF ABSENCE
Dear ________,
§ 1. Purpose of Notice. Please accept this letter as my formal written notice of my intention to take a medical (sick) leave of absence from my employment with ________ (the “Employer”), in respect of which I currently hold the position of ________ in the ________ department.
§ 2. Commencement of Leave. I intend for my leave of absence to commence on ________, and I anticipate that the leave will continue for a period of ________ day(s), subject to any extension that may be medically required.
§ 3. Statutory and Contractual Entitlement.
- This notice is provided in accordance with my entitlement to leave under the applicable employment standards legislation governing my employment, namely the ________.
- Where my employment is subject to federal jurisdiction, this leave is taken pursuant to the medical leave and personal leave provisions of the Canada Labour Code, R.S.C. 1985, c. L-2, including, where applicable, the entitlement to paid medical leave under section 239 thereof.
- Where my employment is subject to provincial jurisdiction, this leave is taken pursuant to the sick leave, medical leave and/or personal emergency leave provisions of the applicable provincial employment standards statute identified above.
- This notice is given without prejudice to, and in addition to, any greater rights or benefits to which I may be entitled under my employment agreement, any applicable collective agreement, or any workplace policy of the Employer (including any short-term or long-term disability benefit plan).
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§ 6. Transition of Duties. I appreciate your understanding and cooperation in this matter, and I will make every effort to ensure a smooth transition of my responsibilities during my absence. Please let me know if there is any additional documentation or information you require to process this request.
§ 7. Anticipated Return. Should I not be in touch during my leave, I plan on returning to work on ________, and I would be pleased to discuss any outstanding matters with you upon my return. I will provide reasonable notice of any change to this anticipated return date.
§ 8. Contact. During my absence I may be reached, for non-urgent matters only, at ________.
Sincerely,
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Date: ________