Blank Employee Excuse Note

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Date:                               

To:                               
(Supervisor/Manager's Name)

From:                               
(Employee's Name)

Reason for Absence:
(Please check one)

• Medical Appointment

• Illness

• Family Emergency

• Personal Reasons

• Other:                               

Date(s) of Absence:
From:                                To:                               

Additional Comments:

                                                                                                                                                                                                                                                                                                            

Signature:                               

Date:                               

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