Resignation – DSP (Direct Support Professional) Form

DSP (Direct Support Professional) Resignation

Fill out this form if you wish to sever all employment with A Helping Hand Senior Care Services LLC.

*If you are a current employee who wishes to transfer to another position within A Helping Hand Senior Care Services LLC, please fill out the Transfer Request Form.

* = Required Information

Who is completing this form

Employee(Self)

Supervisor(or other) on behalf of employee

If you are not the employee, please list your name below, and relationship to the person resigning

Name of employee resigning *

Today's Date *

Two weeks notice given

Yes

Location/Department of current position or float *

Hours currently worked *

Please state last day available to work in current position (we require a two week notice if you wish to be considered for rehire) *

Reason for resignation *

Signature of employee resigning or signature of person completing this form on behalf of the employee *