Open Care Connect - Leave Application Form

Leave Application Form

HR-LAF-001 | V1.1 | Custodian: Quality & Compliance Manager

All leave requests must be submitted a minimum of 2 weeks in advance except personal/carer's leave and emergency leave.

Approval is not guaranteed until confirmed in writing by the manager. Submit this form to your manager and retain a copy for your records.

A - Staff Details

Full Name

OCC Staff ID

Role / Position

Employment Type

Full-Time Part-Time Casual

Direct Supervisor / Manager

Date of Submission

B - Leave Request Details

C - Cover Arrangements

Have you arranged shift cover?

Yes No - Manager to arrange N/A

If yes - person

Are there participants requiring special consideration during your absence?

Yes No

If yes - participant code and nature of consideration (no full names)

Are there pending documentation tasks before your leave commences?

Yes No

If yes - describe and confirm handover plan

D - Staff Declaration

I confirm the above leave details are accurate and complete. I understand approval is not guaranteed and leave without approval may affect my employment.

For personal / carer's leave: I declare that I am genuinely unwell, or am providing care to an immediate family or household member who is unwell, in accordance with the Fair Work Act 2009 and SCHADS Award.

Staff Member

E - Manager Decision

Decision

Approved as requested Approved - modified dates Declined Pending further information

Approved dates (if different from requested)

Reason if declined or modified

Conditions of approval (if any)

Manager Name

Date of Decision

Authorising Manager / CEO

F - Payroll / HR Notes

For payroll and HR use