Legal Templates
Sick Leave Form

Sick Leave Form for India

Sick Leave Form Template for India

A standardized form designed for use in Indian organizations to facilitate and document employee requests for sick leave, complying with Indian labor laws including the Factories Act 1948 and relevant state-specific Shops and Establishments Acts. The document captures essential information including employee details, leave duration, medical circumstances, and necessary approvals, while incorporating provisions for medical certification as required by Indian employment regulations. It serves as an official record for both employer compliance and employee leave tracking purposes, ensuring proper documentation for statutory requirements and internal policy adherence.

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What is a Sick Leave Form?

The Sick Leave Form is a crucial document used in Indian organizations to formalize and process employee requests for medical leave. It is designed to comply with various Indian labor laws, including the Factories Act 1948, state-specific Shops and Establishments Acts, and the Employees' State Insurance Act 1948. The form serves multiple purposes: it provides a standardized method for employees to request sick leave, ensures proper documentation for legal compliance, facilitates appropriate medical certification when required, and maintains accurate leave records for both employer and employee reference. This document is particularly important in the Indian context where sick leave is a statutory right and proper documentation is essential for both legal compliance and employee welfare management.

What sections should be included in a Sick Leave Form?

1. Employee Information: Basic details including employee name, ID, department, designation, and contact information

2. Leave Duration: Specific dates for which sick leave is requested, including start and end dates

3. Nature of Illness: Brief description of the medical condition necessitating the leave

4. Medical Certificate Details: Information about the attached medical certificate including doctor's name, registration number, and hospital/clinic details

5. Leave Balance Statement: Current sick leave balance and leave history for the current year

6. Declaration: Employee's declaration regarding the truthfulness of information provided

7. Approval Section: Space for supervisor/HR approval, including date and signature fields

What sections are optional to include in a Sick Leave Form?

1. Hospitalization Details: Additional section for cases involving hospital admission, including hospital name, admission details, and expected discharge date

2. Emergency Contact: Alternative contact information during leave period, used when employee is seriously ill

3. Post-Leave Work Arrangement: Section for describing work handover arrangements and pending tasks

4. Insurance Claim Reference: For cases where medical insurance is being claimed, including policy and claim reference numbers

5. Follow-up Treatment Schedule: For cases requiring ongoing treatment or future medical appointments

What schedules should be included in a Sick Leave Form?

1. Medical Certificate: Attached medical certificate from registered medical practitioner

2. Company Leave Policy: Reference copy of relevant sections of company's sick leave policy

3. Previous Leave History: Detailed record of sick leave taken in the current calendar year

4. Medical Bills/Reports: Copies of medical bills or diagnostic reports if required by company policy

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

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Jurisdiction

India

Publisher

Genie AI

Document Type

Employment Form

Sector

Employment

Cost

Free to use
Relevant Industries

Information Technology

Manufacturing

Healthcare

Education

Financial Services

Retail

Construction

Hospitality

Public Sector

Professional Services

Telecommunications

Transportation

Energy

Agriculture

Mining

Relevant Teams

Human Resources

Administration

Compliance

Legal

Employee Relations

Operations

Production

Information Technology

Finance

Facilities Management

Relevant Roles

Chief Executive Officer

Managing Director

General Manager

Department Manager

Supervisor

HR Manager

HR Executive

Leave Administrator

Compliance Officer

Employee Relations Manager

Team Leader

Project Manager

Operations Manager

Administrative Assistant

Executive Assistant

Office Manager

Factory Worker

Staff Engineer

Sales Representative

Customer Service Representative

Industries
Factories Act, 1948: Provides basic framework for sick leave entitlement for workers in manufacturing units, including provisions for paid sick leave of up to 12 days annually
Shops and Establishments Act (State-specific): State-specific regulations governing working conditions, leave entitlements, and employment terms for commercial establishments
Employees' State Insurance Act, 1948: Regulates sick leave benefits for employees covered under ESI scheme, including extended illness benefits and medical certification requirements
Industrial Employment (Standing Orders) Act, 1946: Defines terms of employment including leave rules and procedures for applying for sick leave in industrial establishments
State-specific Sick Leave Rules: Various state governments have their own sick leave rules specifying the number of days and conditions for sick leave
Disaster Management Act, 2005 (COVID-19 Guidelines): Recent amendments and guidelines related to sick leave during pandemic situations and quarantine requirements
Maternity Benefit Act, 1961: Relevant for sick leave related to pregnancy and maternity-related illnesses
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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