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Time Off Request Form

The document is a Time Off Request Form for employees to request days off, specifying whether the time off is paid or sick leave. It requires the employee's details, the dates of absence, and approval from a manager or practice lead. Additionally, it includes a section for the manager to confirm approval and check for staff coverage during the employee's absence.

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cllrsr
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Download as DOC, PDF, TXT or read online on Scribd
2 views

Time Off Request Form

The document is a Time Off Request Form for employees to request days off, specifying whether the time off is paid or sick leave. It requires the employee's details, the dates of absence, and approval from a manager or practice lead. Additionally, it includes a section for the manager to confirm approval and check for staff coverage during the employee's absence.

Uploaded by

cllrsr
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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TIME OFF REQUEST FORM

Instructions:

This form is to be completed by the employee and given to the


Department Manager or Practice Lead for approval.

I am requesting ___________ DAYS off. These DAYS are requested as:

□ PAID Time Off □ SICK Hours

1st Day Off: ________________________ Return to Work Date:


____________________

Department ____________________________ Date _________________

__________________________________
_______________________________
Employee Name (Please Print) Employee
Signature

Your Request is:

□ APPROVED □ NOT approved


because

________________________________________________________________________

________________________________________________________________________

___________________________________ ________________________
Manager/Practice Lead Signature Date

To be completed by Practice Lead/Manager

_____ ADDED TO CALENDAR IN MANAGER’S OFFICE


Revised: 3/18/2024
_____ DOES THE EMPLOYEE HAVE PTO/SICK HOURS THAT CAN BE USED?
/conversion/tmp/activity_task_scratch/877469148.doc
__Y/N___ IF APPROVED, WILL THERE BE STAFF COVERAGE WITHIN THE OFFICE?
 IF NO, INFORM MANAGER ASAP

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