Maternity Leave Notification Form

  1. Please ensure that you have read the All About Healthcare Maternity Leave Policy, before completing this form.
  2. Have made an application to the Department of Social and Family affairs for a decision that the person to be cared for is in need of continuous supervision and care throughout the day.
  3. Give written notice no later than 6 weeks before the intended commencement date.

This form should be completed and returned to: HR, Unit 9, Histon House, Cornelscourt, Co. Dublin D18 Y951

Under the Maternity Protection Act, 1994 (Amendment 2007) I hereby notify All About Healthcare of my intention to take Maternity Leave and attach a medical certificate, as requested.

Maternity Leave Form

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Other notifications requirements

Intention to take Additional leave and Notification of return to work
• If I intend to take an additional sixteen weeks’ unpaid leave (Additional Maternity Leave), I understand that I must notify All About Healthcare Human Resources in writing at least four weeks before the end of my maternity leave.
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Office Use:

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