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Personal Emergency Leave Policy Template

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Created by:

[HR Manager.FirstName][HR Manager.LastName][HR Manager.Company]

Prepared for:

[Employee.FirstName][Employee.LastName]

[Employee.Company]

Our company's personal emergency leave policy outlines our provisions for employees who become sick or need to be absent from work for other emergency reasons. The following policy specifies how the personal emergency leave will accrue and how an employee may use it.

[HR Manager.Company] follows legal guidelines applying to sick pay. We also offer (number of leaves) of (paid/unpaid/partially paid) sick leaves. This leave is not included in other types of leaves, such as maternity leave and Paid Time Off (PTO).

[HR Manager.Company] provides employees who pass the eligibility criteria with personal emergency leave under specific conditions.

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Eligibility

All employees working at [HR Manager.Company] for over (required tenure) are eligible for personal emergency leave.

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Reason for Leave

Following is a list of reasons that can be considered for emergency leave.

An employee may take personal emergency leave if they are unable to work (in-house or remote) because:

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Due to a federal, state, or local order related to a contagious disease, they are in isolation or quarantine.

They are caring for someone with a contagious disease and are advised to quarantine with them.

They are self-quarantining due to a contagious disease, as advised by a health care provider.

They are caring for a child whose childcare provider is unavailable.

They are experiencing highly contagious disease symptoms and are seeking a medical diagnosis.

Personal illness, injury, or medical emergency.

The death, illness, injury, or medical emergency of a family member, including the spouse, brother or sister, parent, step-parent, foster parent, child, step-child, or foster child of the employee or relative who is dependent on them for care and assistance.

Personal business of the employee that can not be conducted outside of working hours.

An urgent domestic crisis, such as a natural disaster or burglary.

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Duration/Compensation

Employees at [HR Manager.Company] are entitled to:

Full-Time Employees

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Eighty hours of pay at their regular pay rate.

Sick leave is paid at two-thirds of the employee's regular rate when caring for a family member.

Part-Time Employees

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Pay for the hours the employee works over a two-week period.

Paid leave under this policy is limited to (amount) per day, where leave is taken to care for others and school closures.

Paid leave under this policy is limited to (amount) per day where leave is taken for the employee's illness or quarantine.

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Requesting Leave

Employees who need to take personal emergency leave must provide notice as soon as possible. The normal call-in procedure applies to all leaves and absences from work. The employee may also notify their supervisor through the automated Human Resources Information System (HRIS.)

The notification should include details about how long they will be absent or daily reports for every day of personal emergency leave. In cases where the personal emergency leave is related to an illness or sickness, the employee must submit a physician's note/other medical certification and complete the following sick leave form.

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Leave Rules

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An employee may choose to use personal emergency leave before using any accrued paid leave.

Unused personal emergency leaves may be calculated for the employee's annuity once they retire.

Employees may also accumulate their personal emergency leaves for later years.

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Sick Leave Form

[Employee.FirstName][Employee.LastName]

Employee ID:

Employee Position: [Employee.Title]

Employee Department: (Employee.Department)

Working Days Applying For Sickness Leave:

Start Date: (MM.DD.YYYY)

End Date: (MM.DD.YYYY)

Reason for Sick Leave:

Reminder: If the sick leave is more than three days, a fit-to-work certificate from a physician is required before coming back to work.

By signing below, the employee confirms that all information in this form is true and accurate.

Signature
MM / DD / YYYY

Signature
MM / DD / YYYY

[Employee.FirstName][Employee.LastName]

[HR Manager.FirstName][HR Manager.LastName]

Retaliation

[HR Manager.Company] will not retaliate against employees who request leave in accordance with our personal emergency leave policy.

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Expiration

This policy expires on [Document.ExpirationDate].

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Disclaimer

This personal emergency leave policy template is only meant to provide general guidelines and can be downloaded to fit a company's needs. It does not consider all relevant local and state laws, and this template is not a legal document. The company must alter this template according to local and state laws as well as company objectives before using it.

Personal Emergency Leave Policy Template

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