Request time off forms 2026

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The document is a Request for Time Off form for students at the School of Medicine, outlining the process for requesting time off during clerkships. It details categories for requests, including immediate emergencies, professional conferences, and non-urgent personal reasons, along with guidelines on submission timelines and conditions for approval. The form requires student and clerkship director signatures and includes sections for justifying the request and covering patient care duties during the absence.

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Click ‘Get Form’ to open the Request for Time Off form in the editor.
Begin by entering your name and clerkship details at the top of the form. This ensures that your request is properly attributed.
Fill in today's date and the requested dates for time off. Be specific to avoid any confusion.
Select one category for your request: Immediate Emergency/Illness, Professional Conference, or Non-Urgent Personal Reasons. Each category has specific requirements, so choose carefully.
Provide detailed explanations as required in each section, such as how your patient care duties will be covered during your absence.
Sign and date the form at the bottom before submitting it to the Clerkship Director for review.

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