Care Professional Holiday/Absence Request

1

What is your First Name?* This field is required.

2

What is your Surname?* This field is required.

3

What is your email address?* This field is required.we will send you a confirmation on this email address

4

What is the type of leave your would like to book* This field is required.

Paid Leave

Unpaid Leave

5

Please select the reason for leave* This field is required.Please note, all leave other than annual leave is unpaid. Selecting any other options for paid leave will be subject to approval.

Annual Leave

Appointment

Sickness

Personal/Family Reasons

Compassionate Leave

Maternity Leave

Other

6

Are you looking to book less than 1 full day?* This field is required.For example just the morning for an appointment

YESNO

7

What date would you like leave to start* This field is required.

Date

8

Time

Hour

Minutes

Until

Hour

Minutes

9

What date will be your first day back at work* This field is required.

Date

10

Which Clients will need to be covered while you are away?Please list all clients that will need cover. If no clients require cover proceed to next section

11

Thanks {firstname},

To confirm you are requesting to book {type} with the following reason:

{reason}

The leave is to begin on {leavestart} and end on {leaveend}.

If this is all correct, please hit submit.

12

Thanks {firstname},

To confirm you are requesting to book {type} with the following reason:

{reason}

The leave is on {leavestart} between {timerange}

If this is all correct, please press submit.

13

Unique ID