Time Off Request — Kokua Services

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Folder: Kokua Staff Resources

Employee Request Page

Client Refusal Portal

Time Off Request

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Staff Time-Off Request

Electronic Time Off Request (TOR)

*Expectation: Employees requesting time off will submit the request at least two weeks prior to the requested time off.

*Process: Your completed TOR will be sent to Kokua's Scheduling Manager, Alyssa Madden - you can expect confirmation of receipt for the completed TOR within 3-business days, and follow-up once a decision is made on the request.

Name of Staff Submitting Request: *

First Name

Last Name

Employee Email *

Today's Date *

MM

DD

YYYY

Site(s) Requesting Coverage For: *

Dates requested (please list them out) with Start and End Dates - *

Staff covering shifts (please list them out with specific shifts noted- be sure to have written shift confirmation) *

Have all staff who have agreed to cover given written confirmation of shift acceptance? *

YES

NO

Any additional information you think we should know:

Thank you!

Kokua values respite and will work with each employee to get their time off, but we ask that employees take an active role in securing coverage for their scheduled shifts. PTO may be used for planned time off/vacation, though it is not a PSL qualifying event so employees must find their own coverage.