Leave RequestPlease enable JavaScript in your browser to complete this form.Name *Email *Dates Requested *A minimum of two weeks notice is required for PTO use resulting in a week or more of scheduled absence.Time of Day *AMPMFull DayPTO use in a minimum of 4 Hour IncrementsLeave Type *PTO- ScheduledPTO- UnscheduledUnpaid Leave of AbsenceFuneral LeaveCourt LeaveMilitaryMore than 3 consecutive unscheduled days require doctors release upon return to work. Notes: (Do Not Enter Medical Information)MessageSubmit
