Resident/Fellow Leave Request
Leave requests must be received a minimum of 45 days in advance
Resident Name
*
MAPEREIRA@augusta.edu
DAFARRELL@augusta.edu
AUISAAC@augusta.edu
MAMJAD@augusta.edu
mmagazin@augusta.edu
htrieu@augusta.edu
tefowler@augusta.edu
matfranklin@augusta.edu
sjones27@augusta.edu
ajohnson21@augusta.edu
rotation at time of vacation
*
Cornea
Plastics/Neuro
Retina/General Bogo
Retina - Fellow
General-Ulrich
Peds-Goei/Prosser/Brooks
Glaucoma-Bollinger/Toeteberg
VAMC
Type of Leave
*
Annual/Vacation
Sick/Medical
Off Campus (Mtg,Conf,Etc)
Maternity/Paternity
Job/Fellowship Interviews
Jury Duty
FMLA
Other
disallowed dates
Interview Days (11/1, 11/17, 12/4) VDI Meeting (3/13/24) Resident Research Presentations, (6/19) Graduation Ceremony/Banquet (6/28) PGY 3 OKAP Review Course (2/26/24-03/01/24) PGY 4 Cataract Course (2/15/24 - 2/18/24) Any leave between 6/15 - 8/1
YOU CANNOT TAKE MORE THEN 5 DAYS IN A ROTATION PER YEAR
Date(s) you are requesting off
-
Month
-
Day
Year
Date
Date you will return to clinic/duties
-
Month
-
Day
Year
Date
on call coverage
Comments/Notes
Please use this space for comments and notes regarding coverage of your area(s) while on leave. The number of on-call days one can miss without payback initiated would be 3 per year.
Submit for Approval
Should be Empty: