Time Off Request Form - Home Helpers
All employees/Care Partners must submit requests for time off at a minimum of two (2) weeks prior to the requested time by completing the time off request form either online or in the office.
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Email *
Employee Name *
Last Day Working *
Day and Dates Requesting off (i.e.: Sat, June 1, Sun, June 2) *
Two weeks notice prior to time off? *
Impacts all of your clients scheduled on the dates you are requesting off? *
If time off request does not impact all clients on the dates you are requesting off, please list the impacted clients here:
Is a Caregiver schedule trade possible? (In other words, do you know of a Caregiver(s) that are willing to take some or all of your shifts during your time off and/or possibly trade shifts with you?) *
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