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  • Sickness Self-certification Form

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How to fill out the SICKNESS SELF-CERTIFICATION FORM online

Completing the sickness self-certification form is an essential process for reporting absences due to illness. This guide will help you navigate the form step-by-step to ensure accurate and complete submission.

Follow the steps to fill out the SICKNESS SELF-CERTIFICATION FORM online.

  1. Click ‘Get Form’ button to obtain the form and open it in your preferred online platform.
  2. Begin by filling in your full name in the designated space to identify yourself.
  3. Provide your current address, ensuring all lines are filled for accurate contact information.
  4. State your job title and the department you work in, along with your line manager’s name.
  5. Indicate the regular working days by marking Mon, Tues, Wed, Thu, and Fri to clarify your schedule.
  6. Enter the date your sickness commenced and the date you expect to return to work. This helps in understanding the duration of your absence.
  7. Describe your sickness or injury in detail to provide context for your absence.
  8. Answer whether your absence was due to an accident at work by selecting YES or NO.
  9. If applicable, note whether you completed the Hull OHS(F)2 form with YES or NO, and provide details regarding the accident if it occurred.
  10. Indicate if you have consulted your doctor by selecting YES or NO, and provide the contact details of your doctor if applicable.
  11. Finally, sign and date the form to confirm the information is true and complete, demonstrating your commitment to providing accurate information.
  12. Once completed, save your changes, and download, print, or share the form as necessary for submission.

Complete your documents online to ensure efficient processing and compliance.

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If you're off work sick for 7 days or less, your employer should not ask for medical evidence that you've been ill. Instead they can ask you to confirm that you've been ill. You can do this by filling in a form yourself when you return to work. This is called self-certification.

Mail the completed form to the Division of Driver Licensing, CDL Section, 200 Mero St., Frankfort, KY 40622, or submit the form electronically via My CDL Document Portal at: http://mycdl.ky.gov. For questions regarding this form contact the Division of Driver Licensing, CDL Section at (502) 564-1257.

If you do not provide the self-certification, the medical examiner's certification (card) and any required variance (wavier) within 45 days of the notice from ALEA, then all CDL privileged will be removed from your license.

Many employers have their own self-certification forms. If your employer doesn't have its own form you can download the Self Certification Form. Please print it, fill it in and hand it in to your employer. You do not need to see a Doctor.

You are responsible for providing your valid medical certificate to Virginia DMV. If you do not keep your medical card up to date with Virginia DMV you status will be changed to “not-certified”, your CDL will be canceled and your driver license will be downgraded.

You can get a fit note from a doctor, nurse, occupational therapist, pharmacist or physiotherapist. The healthcare professional treating you can also issue a fit note based on a written report from another healthcare professional. For example: a hospital discharge summary or hospital letter.

Self-certification If employees are off work for 7 days or less, they do not need to give their employer a fit note or other proof of sickness from a healthcare professional. When they return to work, their employer can ask them to confirm they've been off sick. This is called 'self-certification'.

You do not have to keep your medical certificate on file with WA SDL but you must carry it with you when operating a CMV. Per RCW 46.25. 055 CDL drivers must carry Medical Examiners Card in Washington.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232