Request to Excuse an Absence or Tardy
Submission of this request does not automatically excuse an absence or tardy. Traffic is not an excuse for a pattern of regular tardiness. We live in Greater Houston and there is traffic. You can clock in up to 15 minutes early. Please arrive early to your shift. Please allow enough time to take traffic into account. With all that being said, we have had some catastrophic traffic accidents. If there is a major accident that cause everyone to be late, we will consider excusing the incident.
Name
*
First Name
Last Name
Email
*
example@example.com
Which clinic where you scheduled to work?
*
Humble
Spring
Tomball
Houston 1
What is the date(s) you are requesting to be excused?
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
From
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
To
Please explain why you were absent or tardy.
*
Upload a doctor's note or equivalent.
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All of the information provided is true.
*
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