Sick Pay Claim Form
Full Name of Employee
*
First Name
Last Name
Employee Email
*
example@example.com
Employee Payroll Number
*
Profession/Grade
*
Employee Start Date With TTM
-
Month
-
Day
Year
Date
Medical Cert attached
*
Browse Files
Medical Cert must be submitted with Sick leave form on 1st day of absence
Cancel
of
Previous sick pay days claimed
*
Number of sick days already claimed if any in this calendar year
Number of sick pay days you wish to claim
*
In 2024/2025 employees are entitled to 5 days sick pay.'
Confirmation of shift booking
Date & Time Start of Claim 1
*
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date & Time End of Claim 1
*
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location
*
Booking Contact Person
*
Date & Time Start of Claim 2
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date & Time End of Claim 2
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location
Booking Contact Person
Date & Time Start of Claim 3
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date & Time End of Claim 3
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location
*
Ward
*
If not applicable put in N/A
Booking Contact Person
Date & Time Start of Claim 4
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date & Time End of Claim 4
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location
*
Ward
*
If not applicable put in N/A
Booking Contact Person
Date & Time Start of Claim 5
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date & Time End of Claim 5
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location
*
Ward
*
If not applicable put in N/A
Booking Contact Person
Did you notify TTM a minimum of 1 hour before the rostered shift
*
Yes
no
Signature
Submit
Should be Empty: