PT Leave Request Form Department of Physical Therapy Today's Date MM slash DD slash YYYY GatorLink Username*Name* First Last Email* Beginning Date* MM slash DD slash YYYY Beginning Time* : Hours Minutes AM PM AM/PM End Date* MM slash DD slash YYYY End Time* : Hours Minutes AM PM AM/PM Type of Leave* Vacation Sick FMLA Other More than one type of leave may be entered on the application if used during the same period of absence. (e.g. 6 hours of vacation and 2 hours sick leave)If you chose "Other," please provide more information.*Total Hours Absent*(Round to quarter-hour increments: .25, .50, .75, as appropriate. If using multiple types of leave, please indicate how you would like your time allocated.)
