Staff – Emp Request Forms Employee Request Forms Paid / Unpaid Time Off Request Form Name(Required) First Last Email(Required) Phone(Required)Note: Please Request all times within 1 week (Sunday to Saturday). Please submit any other weeks on seperate forms.(Required) I understand. IF "Amount PTO Requested" field is left blank or not completed, accrued time will NOT be used. If the request is under 2 weeks, PTO MAY NOT be approved. Explanation below required if less than 2 weeks. If more than a week submitted, PTO may not be credited on payroll and you may be asked to resubmit.Date Requested(Required) MM slash DD slash YYYY Amount PTO RequestedPlease enter a number less than or equal to 8.00.No time entered = No paid timeDate MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedDate MM slash DD slash YYYY Amount PTO RequestedI acknowledge that "IF" this Schedule Request is not within the requested two weeks notice, my PTO may be denied "AND" I will call the office immediately after submitting. (Short Notices need to be reported to Office Administration for Scheduling Purposes) I understand and will call 859-303-4040 after submitting if less than 2 week notice. Call immediately - If after hours, call and press 0 to speak with the on call manager. Leave Voicemail if not answered.This field is hidden when viewing the formTotal Hours RequestedExplanation if needed Weekly Availability Change Form Name First Last Date the change should start MM slash DD slash YYYY Schedule change requests must be made 2 weeks in advance I have made this request 2 weeks in advance In the fields below, please enter your requested availability in the following format: 8a-5p, 12p-6pSundayMondayTuesdayWednesdayThursdayFridaySaturday Add RemoveEmail Notes PPE - Personal Protective Equipment - Form Name First Last Email Select All That Apply Small Gloves Medium Large Gloves Disposable Masks Reusable Cloth Masks Isopropyl Alcohol Hand Sanitizer Shoe Covers Face Shields Protective Suit Write in Request(s)