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The document is a Critical Illness Application Form (HR113) used for applying for extended paid sick leave under the Critical Illness Protocol, as per HSE HR Circular 014/2018. It includes sections for the employee to provide personal information and medical certification, as well as sections for line managers and senior managers to approve or reject the application. The form outlines responsibilities for communication of decisions, appeals process, and requirements for documentation related to public service pension schemes.

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Versions	Form popularity	Fillable & printable
2019	4.3 Satisfied (42 Votes)
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