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Employee Sick Leave Donation

Forms

  • Request For Donated Sick Leave (pdf)
    Please complete and submit this Request for Donated Sick Leave through your human resources office.

  • Medical Statement For The Transfer Of Donated Sick Leave (pdf)
    Completed form must be mailed or faxed by the medical office directly to the Technical Services division.

  • Sick Leave Donation Agreement (pdf)
    Employees must agree to donate a minimum of five (5) days of sick leave (37.5 hours for employees on a 7.5 hour per day work schedule or 40.0 hours for employees on a 8 hour per day work schedule) and may not donate more than one-half of the sick leave balance in effect at the point leave is first deducted from the balance. Also, employees may not donate more than a total of ninety (90) days of sick leave during their employment with the State of Tennessee.