Request for Time Off

Request Care(713) 686-2233
Request for Time Off 1

REQUEST FOR TIME OFF

This form should be completed and turned in to a care coordinator (by clicking “Submit”) two weeks before the requested time off date. Requests for time off on holidays must be submitted 30 days in advance. We cannot guarantee approval of late submittals.

Encore Caregivers will endeavor to approve your request, subject to staff availability and client needs.

Encore Caregivers’ Holidays

Easter, Mother’s Day, Memorial Day, July 4th, Labor Day,
Thanksgiving Day, Christmas Eve (from 12 noon), Christmas Day,
New Year’s Eve (from 12 noon), and New Year’s Day

Request for Time Off

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Employee Name:*

I am requesting time off from work as follows:

I understand that requests for time off are subject to approval by Encore Caregivers. I understand that assigned schedules are still in effect until I am notified by Encore Caregivers that this request for time off has been approved.
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