Affinity Health

REQUEST FOR TIME OFF

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EMPLOYEE REQUEST FOR TIME OFF

Please fill out the form below if you would like to officially request time off.  Your Supervisor will receive a copy of this form (please enter their email correctly below) and a copy will be sent to Head Office HR department. 

Your Supervisor must approve any requests for time off before they can be taken.  Please follow up with your Supervisor for any questions. 

Request for Time Off

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
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