Report A Problem

What is the nature of the problem?
Name of caller *
Contact telephone number *
Caller's company *
- Caller's work location/department *
- Caller's manager *
  Include both first and last name or specify in notes why full name was not given
Absence start date
Expected return to work date
Confirmed return to work date
Reason for absence *
Notes/details *
Please include as much information as possible including the reason why you had to complete the RAP and any details about the absence
Name of call handler *
  Message given *
  Message given *
* Required fields