Request for Service - Other Services

Describe the nature of your request and attach the necessary form. Submit a separate request for every item. https://www.unlv.edu/medicine/hr

Requester Information

First Name*

Last Name*

E-mail Address*

Departments*

Select or enter value

Phone Number

Service Requested*

Select

Details

State in detail, your questions or inquiry, including dates, times, frequency, so we may be able to help you in a timely manner.

Details*

Additional information

Attachments required

Special Instructions for Attachments based on Request For Other Services (review before submission or may cause delays)  For Benefits – state your question in detail;  For Leave / Time Off - state your inquiry;  For One Time Payment or Extra Contractual Compensation (ECC), attach completed and signed ECC form or 1 time pay timesheet;  For Payroll – state your question in detail;  Add all other information and uploads in the Additional Information field

File Attachments

Drag and drop files here or

Send me a copy of my responses

Privacy Notice|Report Abuse