| Employee | |
|---|---|
| Date of Request: | 05/16/2026 |
| Clinic | Kosciusko |
| Time Requested Off | |
| Is this request for multiple days? | Yes |
| Initial Date Requested off | 06/17/2026 |
| End Date Requested off | 06/24/2026 |
| Has anyone else already scheduled off during this time? | No |
| Approved? (Admin-only) |
|