Paid Sick Time Request Form

Washington law provides transportation network company (TNC) driver partners the opportunity to accrue and use paid sick time to care for their own or a family member’s health and safety under qualifying circumstances (“Paid Sick Time”).

Qualifying circumstances for using Paid Sick Time include:

1. An absence caused by a driver partner's mental or physical illness, injury, or health condition;

2. To accommodate the driver partner’s need for medical diagnosis, care, or treatment of a mental or physical illness, injury, or health condition, or a driver partner's need for preventive medical care;

3. To allow the driver partner to provide care for a family member for the same reasons;

4. When the driver partner's place of business has been closed by order of a public official for any health-related reason, or when a driver partner's child's school or place of care has been closed for such a reason;

5. Absences that qualify for leave under the Domestic Violence Leave Act; or

6. During a deactivation or other status that prevents the driver partner from performing network services on the TNC's platform, unless the deactivation or status is due to a verified allegation of sexual assault or physical assault perpetrated by the driver partner.

Please see Via’s Paid Sick Time Policy for additional details.

To request Paid Sick Time, please fill out the form below. You can claim more than one day per submission by tapping "Add Another Date".

What is your name?

What is your email? (Must be the email associated with your Via account.)

Select Dates

I am claiming Paid Sick Time for the following date:

I am claiming the following number of Paid Sick Time hours (note that Paid Sick Time can only be used in 4-hour increments).

4 Hours8 Hours

By submitting this request, I confirm that my request for Paid Sick Time is for a qualifying circumstance and is consistent with Via's Paid Sick Time Policy.

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