MCN’s customizable template, Request for Revised/Excused Duty Form, is taken from our Home Infusion Therapy Policy and Procedure Manual. MCN Healthcare’s proven policy and procedure templates, competencies and compliance tools have assisted more than 20,000 health care organizations worldwide meet their regulatory compliance goals.

MCN provides more than 80 health care specific policy and procedure manuals for Acute Care Hospitals, Ambulatory Care, Behavioral Health, Home Health, Physician Practice, and Long Term Care. MCN’s policy and procedure manuals focus on the latest healthcare "hot topic" issues related to patient safety and prevention of medical healthcare errors.

Here is some sample content from Request for Revised/Excused Duty Form:

	REQUEST FOR REVISED/EXCUSED DUTY Staff Member Name: Unit Involved: Supervisor's Name: Request: Reason: q Approved If rescheduled, list rescheduled assignment and dates: Name of individuals replacing staff member during revision of schedule: q Denied If denied, list rationale: Signature of Department Manager: Date/Time Received: ?? ?? ?? ?? 1 Reference #1013 Home...
Second excerpt:
	...Name: Unit Involved: Supervisor's Name: Request: Reason: q Approved If rescheduled, list rescheduled assignment and dates: Name of individuals replacing staff member during revision of schedule: q Denied If denied, list rationale: Signature of Department Manager: Date/Time Received: ?? ?? ?? ?? 1 Reference #1013 Home...