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Request For Use of Vacation Time or Personal Days: Please Complete and Submit This Form To Your Provider/Office Manager

This document is a request form for employees to use vacation time or personal days. The employee fills out their name, title, dates requested off, and amount of earned time. They sign and date the form which is then given to the provider/office manager to approve or deny the request. If denied, the manager notes a reason and signs with the date.

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Archon Rehabh
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39 views

Request For Use of Vacation Time or Personal Days: Please Complete and Submit This Form To Your Provider/Office Manager

This document is a request form for employees to use vacation time or personal days. The employee fills out their name, title, dates requested off, and amount of earned time. They sign and date the form which is then given to the provider/office manager to approve or deny the request. If denied, the manager notes a reason and signs with the date.

Uploaded by

Archon Rehabh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Request for Use of Vacation

Time or Personal Days

Please complete and submit this form to your Provider/Office Manager.

Request Date Employee Name (First and Last Name)

Office Title Vacation Time/Personal Time Earned


-

Please fill in the dates you are requesting off Day you plan to return to the office

Employee Signature Date

Provider/Office Manager to Fill in Below

Approved or Not Approved Total Amount of Days/


Hours Requested by Employee

If NOT Approved, Explain Why

Provider/Office Manager Date

[OFFICE ADDRESS] [PHONE NUMBER] [EMAIL]

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