Time Off Request

Sent to the Supervisor and Office Manager for approval.

Reason
Business days until requested dates off
Choose your dates

It is each clinician’s responsibility to transmit this form 5 business days before the request to both the Supervisor (who has final determination of the request’s status) and the Office Manager (who is responsible for rescheduling and providing a mechanism of confirmation for the switched time). This is in order to maximize billable hours. Each person is responsible for communication with other team members when you will be out of the office.

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