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Fill - Free fillable 113ci HR113 Critical Illness form PDF 2025

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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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