Please complete this form for any shift where you will be coming in late, leaving early, taking time off in the middle of your shift, or calling out of the entire shift. Please also use this form for any shift trades or shift coverages. Shift/trades and coverages will either show up on the staffing sheet or in your BI schedule depending on how far away the trade is. We ask that you follow all shift/trade guidelines when doing shift trades. For more information see our Attendance Policy.
This form is not for vacation/PTO requests. Please submit any vacation/PTO requests directly into ADP with more than 2 weeks notice.
What are the start and end times of the extended mid-shift break?(Please list them in the Pacific Time Zone):
Please troubleshoot with your supervisor. If the problem still persists, please submit a Help Desk ticket here: https://linesforlife.sd.cloud.invgate.net/portal
SICK Time
This time can be used for the purpose of improving the employee’s physical, mental, or emotional wellbeing.
Eligibility: All employees.
Allowed Amounts:
Notification Requirements:
Note: Collaborative communication is encouraged between employees and supervisors.
WELLNESS Days
Paid days for employee physical, mental, or emotional wellbeing.
Eligibility: All Employees
PTO
Time off taken in connection with vacation, personal business, and holidays.
Eligibility: Employees who regularly work 20+ hours per week
Extended Illness Bank (EIB)
Paid time off hours that are accessible for family and medical statutory leaves if an employee is off for more than 3 consecutive days after exhausting accrued and available sick time.
Eligibility: All employees who have had excess hours rollover from their sick time and/or PTO hours during the annual rollover(s).
Bereavement
Supports employees in grieving and handling affairs following the death of a loved one.
Eligibility & Allowed Amounts:
Note: Must be requested through HR Helpdesk and the supervisor.
Critical Incident
Employees who have been directly involved in a traumatic incident including of on-duty violence by a client in which the client engages in violence toward self or others while actively engaged in services provided by the employee where emergency medical services were involved, and the employee themselves was not physically injured, may make a request to their manager or supervisor to be relieved for the remainder of their shift, which shall be on paid time.
Eligibility: Must meet the critical incident definition above.
Note: This ensures space to emotionally recover from on-duty traumatic experiences.
Jury Duty
Covers time off when employees are called to serve on jury duty.
Eligibility: Employees who have completed their probationary period to receive paid jury duty.
Other Notes:
Witness Duty
For court appearances required by subpoena or court order.
Eligibility: Applies to employees who have received job-related or personal subpoenas or court orders.
Note: Notify supervisor as soon as possible.
I don't have enough paid time (Personal Leave)
When an employee is ineligible for or has exhausted other leave options, they may request a personal leave of absence that is at the discretion of the employer to approve or deny.
Eligibility:
Note: Requests must be submitted in writing, and responses will be provided within five business days.
N/A
I don't need anything added since it's:
Inclement Weather and Disasters
Employees are expected to make every reasonable effort to work assigned shifts. When severe weather conditions or related emergencies make it unsafe or unable to telework, there is a limited amount of Inclement Weather leave available.