Appendix: Overtime Request Form

To earn payment for either type of overtime, nursing personnel must obtain preapproval from their supervisors through the Overtime Request Form.

Table of Contents


A copy of the overtime request form.  It includes a place for a person’s name, employee ID, job title, week ending date, and current location.  It has a location to input the amount out time being requested for OT.  The form needs the employee’s signature, the supervisor’s signature, and the department director’s signature.
Date published: March 30, 2021

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