Notification of Absence (V-code Doctor)

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Upon receipt of your absence notification, Human Resources Department will send out an acknowledgement email to you regarding your absence details and absence balance

Should you have any enquirers, please feel free to contact Mr Maurice Pun at 2608 6751 or Mr Kelvin Tse 2608 6750 or email to vms@union.org

*V-Code Doctor is the "Key Individual" appointed by his/her own "Consultant" to be admitted to Union Hospital as a visiting medical staff during a specified Term as stipulated in the Agreement of Services between Union Hospital and his/her Consultant Firm. Doctor shall consult his/her firm for details of absence entitlement.

Email *

Name of Doctor
*

Doctor Code *

Specialty *

Other Specialty

Absence Start Date *

YYYY

[Start Date] AM/PM *

Absence End Date *

YYYY

[End Date] AM/PM *

Total Number of Absent Working Days *

Reason of Absence *

Work related absence

Non-work related absence

Availability *

Available by mobile and email

Available but limited access to email

Unavailable, please contact the covering doctor

Duty will be covered by (Please provide the doctor's name) *

Remarks

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms