Revoke/Terminate Remote Work Participation Agreement

This form is to be completed by the HR Business Partner or Supervisor. Remote work means an arrangement by which an employee works from a remote location other than the primary worksite, either for part of their schedule or entirely. Participation is voluntary subject to the university’s approval. Participation is not an employee right or benefit, and may need to be discontinued for business reasons. Regular office means the employee's usual and customary work address. It remains the primary work location even if participating in a remote work arrangement. Please note: This form is to be submitted to revoke or terminate an existing remote work participation agreement. Alternative Work Schedules and Remote Work Arrangements Policy: https://www.ucdenver.edu/docs/librariesprovider284/default-document-library/4000-human-resources/4032---alternative-schedules-and-remote-work-arrangements.pdf?sfvrsn=3ee7f3ba_2 Please note: It will take approximately 20 minutes to receive a copy of the form. For questions, please reach out to your department's Human Resources Business Partner.

Remote Work Participation Agreement - Revoke/Terminate

Instructions:

This form is to be completed by the HR Business Partner or Supervisor. This form is to be submitted to revoke or terminate an existing remote work participation agreement.

Please select the reason for revoking or terminating this agreement.*

Business/Unit Operational needs

Employee choice

Performance

Please contact your Employee Relations and Performance Consultant prior to completing this form.

Please refer to the following link for your designated Central HR Employee Relations and Performance Consultant. https://www1.ucdenver.edu/offices/human-resources/human-resources-home/human-resources-staff-listing-by-school-college-consolidated-unit-and-department

Employee First Name*

Employee Last Name*

Employee Email*

Employee ID Number*

Employee IDs are 6 digits.

Effective Date*

Principal School/College/Department*

Select

Department, Division or Work Unit*

Select

Department, Division or Work Unit*

Select

Department of Medicine Work Units*

Select

Supervisor First Name*

Supervisor Last Name*

Supervisor Email*

Department Approver/Unit Human Resources Business Partner First Name*

Department Approver/Unit Human Resources Business Partner Last Name*

Department Approver/Unit Human Resources Business Partner Email*

Have you discussed the termination of the Remote Work agreement with the employee? Please check the box.*

Yes, I, the Supervisor or HR Business Partner have discussed the termination of the Remote Work agreement with the employee.

𝗣𝗹𝗲𝗮𝘀𝗲 𝗻𝗼𝘁𝗲: It will take approximately 20 minutes to receive a copy of the form. If you do not see the confirmation email in your inbox, please check your junk and clutter folders.

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