PTO Request

HomePTO Request

30 days notice is required for time off requests. We will do our best to honor time-off requests based on availability. Requests are granted on a first come, first serve basis.

Date of request (*)

Employee Type: (*)

Name (*)

Email (*)

List a TEAMMate that will be covering your group (therapist) or hours/core job duties (admin) :

Date

From:

To:

Date

From:

To:

Date

From:

To:

Date

From:

To:

Date

From:

To:

Please list alternate hours you would like to work instead of using your PTO time

Please provide the reason for PTO request:

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