This form is only to be completed by Manager/Supervisors and should NOT be filled out by employees. The information collected on this form will be used to populate a COVID-19 Telecommuting Approval Letter for a UConn Health employee. A separate form must be filled out for each employee. You must complete ALL fields before you will be able to submit the form.
The use of this online form to request temporary telecommuting privileges will no longer be applicable after 08/15/2021. To request a permanent work from home agreement, please see the UConn Health Telecommuting Policy, UConn Health Telecommuting Guidelines, and UConn Health Telecommuting Request From