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Call Off Form

The Call-Off Form is used by employees to report shifts they were called off from, ensuring payroll is notified for tracking purposes. It is important to submit the form to Aya after each call-off to determine eligibility for pay, with a potential delay in payment. The form must be submitted by the following Monday and does not apply to voluntary shift reductions.

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817 views1 page

Call Off Form

The Call-Off Form is used by employees to report shifts they were called off from, ensuring payroll is notified for tracking purposes. It is important to submit the form to Aya after each call-off to determine eligibility for pay, with a potential delay in payment. The form must be submitted by the following Monday and does not apply to voluntary shift reductions.

Uploaded by

stonyyapper
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Call-Off Form

Employee:__________________________
Kimberly S. Oliver 5/14/23-8/19/23
Contract Dates:__________________________

Every facility has a different call off policy and most do not report call off shifts to Aya. This is why it is important that if
you are ever called off of a shift, you use this form to alert payroll. Please send the form to Aya whenever you add a new
call off shift. This will help us track your shifts to see if you have exceeded your facilities limit for call offs and are eligible
for pay for the call offs. All call off shifts reported to Aya will be sent to your facility for approval, therefore there is likely
to be a lag of a week in payment (if owed) for a call off shift. Please track all call offs on this same form and add as your
assignment continues. The form must be received the Monday after your call of shift.

**Please Note: If you volunteer to go home it does not count as a call off**

Please email to your payroll representative.

Did you call in sick


Date of call off/ during this pay Total hours
sent home Hours Hours Were you offered period or volunteer called off or Manager
early Scheduled Worked another shift? to go home? shorted Signature

5/29/23 12 0 No No 12

6/5/23 12 0 No No 12

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