Healthcare Collective Bargaining Agreement Waiver Request Form
Submit your request to waive specific provisions of the healthcare collective bargaining agreement. Please provide accurate information for efficient processing.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization or Department
*
Role or Position
*
Which provision(s) of the collective bargaining agreement are you requesting to waive?
*
Reason for Waiver Request
*
Submit Waiver Request
Should be Empty: