USC Radiology - Request For Time-Off
In order to process your Request for Time-Off, you will need to complete the following form. PLEASE USE YOUR
email address. If the RTO is not complete, the form will be returned. Once filled out appropriately, it will be submited to Division Head for approval. The response will be forwarded electronically to faculty/fellow.
Your Email Address:
Support Staff Email:
Full Name (first, last):
Vascular & Interventional Radiology
Academic Leave (paper)
Cancel Leave Request
RTO benefit to the department:
For Academic, CME, Departmental or Grant Leaves: Provide which Meeting, Title of the Presentation, and Location:
Dates Requested (from):
Dates Requested (until):
Total Days requested:
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