Sitefinity Formstack Anschutz Test Form

Name*

First Name

Last Name

Trainee Email*

Clinic Director Email*

Prelims: choose "Nicole.CanterburyPassoth@CUAnschutz.edu" since you do not have a clinic director.

My request is:*

A NEW vacation request (not previously scheduled) To CHANGE a currently scheduled vacation request

For your NEW vacation request (not previously scheduled) please enter the dates of your request below in MM/DD/YYYY format.*

Based on the date I am submitting this form for a NEW vacation request, the earliest date that is affected by this request is:*

60 or less days out 61 to 120 days out 121+ days out

For your CHANGE request, please enter the dates of the currently scheduled vacation days you would like to change:

Please enter the new dates you are wishing to swap the above vacation days for. Please keep in mind that per GME, weekend days can only be swapped for weekend days:*

Based on the date I am submitting this form to CHANGE a currently scheduled request, the earliest date that is affected by this request is:*

60 or less days out 61 to 120 days out 121+ days out

Request Denied

Per our vacation request policy, all vacation requests submitted 60 days or less from the start of the request are automatically denied. If you have questions, please contact Nicole Canterbury-Passoth at Nicole.CanterburyPassoth@cuanschutz.edu

Thank you for submitting your vacation request form. This request will be routed to your clinic director and program administration for approval. Please reach out to Nicole Canterbury-Passoth with any questions (Nicole.CanterburyPassoth@cuanschutz.edu).

Thank you for submitting your vacation request form. This request will be routed to program administration for approval. Please reach out to Nicole Canterbury-Passoth with any questions (Nicole.CanterburyPassoth@cuanschutz.edu).

University of Colorado Anschutz Medical Campus

Anschutz

Trainee Vacation Request

Clinic Director Approval

Program Administration Review and Approval