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Employee Call-Outs

You must give 24 hour notice.

If the call out is due to a medical emergency, please submit Doctors letter upon returning to work. Doctors letters can also be faxed to (203) 306-3277 or emailed to (

In addition to filling out the form below, you must verbally call scheduling to discuss the call out.

If you have multiple clients, please enter all client names below.  

If employee has not contacted scheduling verbally with-in the same date of submission , to confirm when employee will be returning, employee cases will be reassigned. 

Thank You in advance for your cooperation.