4560 g-2026

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The document SF 4560-G (9-2018) provides detailed instructions for completing the Physician’s Certificate of Illness/Injury (PCII) required for employees at Sandia National Laboratories who are absent due to illness or injury. It outlines the responsibilities of both managers and employees regarding the submission of the PCII, eligibility for sickness absence benefits, and compliance with the Family Medical Leave Act (FMLA). The document specifies conditions under which a PCII is necessary, guidelines for medical practitioners authorized to complete it, and procedures for returning to work after an absence.

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Click ‘Get Form’ to open the 4560 g in the editor.
Begin by filling in your personal information, including your name, SNL ID number, and contact details. Ensure that the first day of absence is clearly indicated.
In the section titled 'Description of Job Duties/Responsibilities', provide a brief overview of your job role. This helps your physician assess your ability to return to work.
Complete the Authorization for Release of Medical Information section. This is crucial for obtaining paid leave under HR007 Time Away from Work.
If applicable, have your physician fill out their portion of the form, detailing treatment dates, diagnosis, and any restrictions upon returning to work.
Review all entries for accuracy before submitting. Once completed, send the form back to Sandia National Laboratories’ Health Services using the provided contact methods.

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