Request for a change in the Sick Leave

Instructions for patients when issuing an electronic Sick Leave at the Hospital Jihlava

Any changes you need to deal with the Sick Leave should be made through this formor scan the QR code from this site with your mobile device.


Fill in the form in case of:
  • Certificate of Sick Leave continuation. After 14 days from the date of issue, if the sick leave continues, you should always ask for a confirmation on the last day of the month.
  • Changing the time off during the sick leave duration.
  • Change of the place of residence during the duration of a sick leave, for serious reasons.
  • Termination of a sick leave.

Changing the Sick Leave can be done by using the form on the Hospital Jihlava website or by checking with a doctor in the clinic.

Send your requests using the form Monday - Friday till 12:00.

The request will be handled the following workday.

Requests sent at the weekend or on a holiday will be processed the next working day, i.e. the change requested for the weekend must be notified by 12:00 on Friday at the latest.

Requests for retroactive changes will not be considered.

Submit the Sick Leave to your doctor at every check-up.

After filling in the form you will receive a confirmation text message, you do not need to verify by phone.

If you fail to attend a scheduled check-up without an excuse, your sick leave will be terminated.

If you had your Sick Leave transferred to a GP or a specialist, you will be dealing with them.

If you have a question regarding a sick leave, please call on weekdays between 10:00-12:00 at tel. +420 567 157 379, +420 567 157 710