Scribd Logo
Upload

Welcome to Scribd!

  • 12 views

    Eisenhower Medical Center Graduate Medical Education: Revised 6/7/2018

    Uploaded by

    risingdead
    This document is a request form submitted by resident Sushant Soni to Eisenhower Medical Center's Graduate Medical Education department requesting time away from his residency program. Soni is requesting 9 days of planned time off from September 17-20, 2018 and May 13-17, 2019 to take electives. He will return to work after each period of absence. The time away is classified as paid time off to be used for electives.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content

    You might also like

    Eisenhower Medical Center Graduate Medical Education: Revised 6/7/2018

    Uploaded by

    risingdead
    12 views1 page
    This document is a request form submitted by resident Sushant Soni to Eisenhower Medical Center's Graduate Medical Education department requesting time away from his residency program. Soni is requesting 9 days of planned time off from September 17-20, 2018 and May 13-17, 2019 to take electives. He will return to work after each period of absence. The time away is classified as paid time off to be used for electives.

    Original Description:

    pr gtre

    Original Title

    Pto Update

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is a request form submitted by resident Sushant Soni to Eisenhower Medical Center's Graduate Medical Education department requesting time away from his residency program. Soni is requesting 9 days of planned time off from September 17-20, 2018 and May 13-17, 2019 to take electives. He will return to work after each period of absence. The time away is classified as paid time off to be used for electives.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    12 views1 page

    Eisenhower Medical Center Graduate Medical Education: Revised 6/7/2018

    Uploaded by

    risingdead
    This document is a request form submitted by resident Sushant Soni to Eisenhower Medical Center's Graduate Medical Education department requesting time away from his residency program. Soni is requesting 9 days of planned time off from September 17-20, 2018 and May 13-17, 2019 to take electives. He will return to work after each period of absence. The time away is classified as paid time off to be used for electives.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    EISENHOWER MEDICAL CENTER

    GRADUATE MEDICAL EDUCATION


    RESIDENT TIME AWAY REQUEST 2018-2019

    Resident Name: ____SUSHANT SONI________________________________________

    Date(s) of Absence: From: __ 9/17/18_______ Through: _______ 9/20/18________________________


    Date(s) of Absence: From: __ 5/13/19_______ Through: _______ 5/17/19________________________
    Date(s) of Absence: From: _______________ Through: ____________________________________
    Date(s) of Absence: From: _______________ Through: ____________________________________

    Number of work days missed: ___9____________ Return to work date: ________________________


    Rotation: ___Electives________________________________________________________________

    The time away is requested as (use comment line as necessary):


    __X____ PTO/Planned Time Away ________ Conference
    ________ Illness/Injury/Medical ________ Jury Duty
    ________ Bereavement Time ________ Leave of Absence
    ________ Military Leave or Duty ________ Step 3 Exam / Travel Day
    ________ Paid Time-Off – not to be deducted from PTO (e.g. GME responsibilities,
    speaker on behalf of residency or hospital, poster presentation, etc.).

    Signature of Requesting Resident:

    ___________________________________________________________

    Revised 6/7/2018

    You might also like