Uncertified sick leave [Delete this line]
[Company name]
[Sender address]
[date]
[Recipient name]
[Recipient address]
Dear [Recipient first name],
We have written to you on two recent occasions on [dates of previous letters] regarding your absence from work because of [sickness/injury] [since [date]/from [date] to [date]], asking you to submit a doctor's statement of fitness for work to cover your absence. However, you have not responded to either letter, nor have you provided a doctor's statement. Your absence from work [has, as of the date of this letter, lasted for [state number of days/weeks since the start of the employee's absence]/lasted for [number] days]. We are concerned that you have failed to provide a doctor's statement, and that you have not made contact with us, despite our requests.
In our last letter to you, dated [date], we informed you that, if you did not respond to the letter or provide a doctor's statement of fitness for work to cover your absence by [date given in last letter for the employee to respond], we would have no option but to treat your absence as unauthorised and instigate disciplinary action against you. We enclosed a copy of our disciplinary procedure with that letter [with the relevant sections highlighted]. We also invited to you to contact us if there are any extenuating circumstances regarding your absence.
Unfortunately, we have still not heard from you, nor received a doctor's statement covering your period of absence. We must therefore regard your absence as an unauthorised absence.
Accordingly, we would like to invite you to attend a disciplinary hearing at [time] on [date] at [place], which will be held under our disciplinary procedure. The interview will be conducted by [name of manager] [and [name of other person] will also be present].
The purpose of the interview will be to discuss your absence from work and the reason why you have failed to provide a doctor's statement and failed to respond to our letters. We believe that this may constitute gross misconduct under [Company]’s disciplinary procedure.
You may, if you wish, bring a colleague or trade union representative of your choice to the interview either to represent you or to act as a witness.
Depending on the facts established at the interview, the outcome could be disciplinary action up to and including summary dismissal (i.e. dismissal without notice or pay in lieu of notice), but no decision will be made until you have had a full opportunity to explain your conduct and the interview has been concluded. If there are mitigating circumstances, we will of course take these into account.
I look forward to having the opportunity to discuss your circumstances with you at the interview.
Yours [faithfully | sincerely],
[Sender name]
[Sender job title]
[Sender telephone]
[Sender email]
