UT System Administration Employees: Self-Isolation and COVID-19 Notice

Questions marked with a * are required
This form is to be completed when an employee of the UT System Administration is requesting an alternative work schedule; requesting annual, sick or administrative leave; or is absent for reasons related to COVID-19. This form may be completed by the affected employee or the affected employee's supervisor.

Anyone with questions is encouraged to contact the UT System Office of Human Resources by emailing systemhr@tennessee.edu or by calling 865-946-8847.  
Type of Request (Select all that apply)
Employee's Contact Information
Contact Information for Employee's Direct Supervisor
Reason for Request (Select all that apply to the employee)
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