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Queen's University - Department of Surgery Training Program

Off Service Residents Time Off Request Form

This form is to be used by residents from programs outside of Department of Surgery.

  • Request MUST be submitted no later than 4 weeks prior to the start date of the block you are requesting time off for.
  • The Program manager will request approval of your request from the Chief Residents and the Program Director and will input approved leave into your WebEval system notififying you when a final decision has been made.
  • Should your vacation be denied, you will be notified immediately and an alternate leave period will be suggested.

ATTENTION: General Surgery and Ortho Residents


All General Surgery and Ortho Residents should use the Resident Calendar login located here

If you require assistance please contact the Department of Surgery:

Kim Telford

Part 1: Resident Identification

    • This Email Address will be used to send you the acceptance or denial of this request.

      Please ensure it is entered correctly

ATTENTION: PLEASE READ THE VACATION GUIDELINES CAREFULLY BEFORE SUBMITTING THIS FORM. By Submitting this form, you are indicating that you have read and accept the guidelines.

Part 2: Enter Vacation Request Details

    Part 3: Submit Request

    Confirm all time off request details are correct before submitting.

    Once the form has been submitted, make sure to check your email for confirmation that the request has been received. If you do not receive an email, contact the Internal Medicine Program Office.

    Note: An email is also sent to the Home Program Office as selected within the "Home Program" Drop Down Box above.

    The Internal Medicine Program office will provide you with an acceptance or denial response within 14 days.

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