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HOLIDAY PROGRAM 2024/25
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Staff -
Sickness Certification Form
1. This form is to be completed on your return to work following any period of Sickness or Absence from work.
*
Indicates required field
I am submitting this form for the following reason:
*
Sickness
Absence
NAME:
*
First
Last
Email
*
Phone Number
*
Sickness or Absence BEGINS on DATE:
*
Sickness or Absence BEGINS on DAY:
*
Sickness or Absence BEGINS from TIME AM/PM:
*
Sickness or Absence FINISHED on DATE:
*
Sickness or Absence FINISHED on DAY:
*
Expected date of return to work from Sickness or Absence:
*
Please provide details of the Sickness or Absence
*
Did you consult a Doctor
*
YES
NO
If YES, please give details of the DOCTOR NAME, ADDRESS, DATE OF VISIT, TREATMENT & ANY CURRENT TREATMENT
*
If NO, Please state the reason why you did not see a Doctor
*
H2O OFFICE USE ONLY:
*
- Approved / Not Approved
- Program Manager Advised
- Recorded on Personnel file
Submit to H2O Office
HOLIDAY PROGRAM 2024/25
HOME
Dates - TERMS
Dates - CLOSED
Dates - HOLIDAY INTENSIVE
NEW STARTERS - FAQs
Owner Background
Dryland Certificates (NEW)
Terms and Conditions
Blog
MY SWIM ACCOUNT
Give to Get
LEARN TO SWIM
H2O Program
LAURISTON = Enquire / Book Free Assessment
GEELONG TWC = Enquire / Book Free Assessment
Frequently Asked Questions
News
VENUES
ARMADALE - Lauriston Girl's
TOORAK - Geelong Grammar
ADULT SWIM
Adult Learn to Swim
Stroke Correction / Development
Want to find out more ?
CONTACT
Lauriston Contacts
Geelong Contacts
My Swim Account - HELP
Employment
Getting Qualified
Your Feedback
SHOP