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Request for Leave of Absence Form Template

Streamline Your Leave of Absence Process with This Template

Navigating the leave of absence process can be challenging for both employees and employers. Our Request for Leave of Absence Form Template is designed to help you clearly communicate your time off needs while capturing all essential details regarding your absence. This template simplifies the process of applying for leave, ensures you receive proper documentation for HR records, and helps you avoid misunderstandings about your return date, all while being fully compliant with hiring policies and procedures. Explore the live template to get started.

Full legal name
Employee ID
Department or team
Work email
Type of leave requested
Please Specify:
Reason for leave (do not include sensitive details you prefer not to share)
First day of leave
Expected return-to-work date
If partial day(s), specify hours or schedule
Leave duration
Full day(s)
Partial day(s)
Combination of full and partial days
Not sure
Best contact email during leave
Best contact phone during leave
Have you arranged work coverage for your responsibilities?
Yes
In progress
No
Not applicable
Manager or supervisor full name
Manager email
Have you informed your manager about this request?
Yes
No
Supporting documentation will be provided if required (e.g., medical note)
Yes
No
Not applicable
I acknowledge I have reviewed the applicable leave policies
Strongly disagree
Disagree
Neither
Agree
Strongly agree
Type your full name as signature
Date signed
I certify the information provided in this request is accurate and complete
Strongly disagree
Disagree
Neither
Agree
Strongly agree
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Paper art illustration related to Request for Leave of Absence Form Template and FormCreatorAI

When to use this form

Use this form when you need time away from work longer than a few days, so you can set clear dates, reasons, and coverage. It fits medical recovery, caring for a family member, bereavement, education, military duty, or personal matters. You get a documented request and faster decisions; managers get the details to plan staffing and payroll. If your need is a short illness, use the Sickness leave form instead. Expecting a child? Submit a Maternity leave application form for parental leave. Planning a regular trip, not an extended absence? A Vacation request form is a better fit. This template helps coordinate handoffs, protect benefits, and confirm your return plan.

Must Ask Request for Leave of Absence Questions

  1. What is the primary reason for your leave?

    A simple category (medical, family, education, military, personal) tells HR which policy applies and what documentation may be needed. It also helps your manager plan coverage without exposing private details.

  2. What are your requested start date and expected return date?

    Clear dates let teams plan staffing, deadlines, and system access. They also set expectations for check-ins and help payroll handle any pay changes.

  3. Will your time away be continuous or intermittent?

    This shows whether you will be out in one block or on a recurring schedule. It guides scheduling and avoids confusion about availability.

  4. How will you handle pay during your leave (PTO, unpaid, or donated PTO)?

    Stating your plan early prevents payroll issues and surprises on your paycheck. If you may need support, you can coordinate a PTO donation using the PTO Donation form.

  5. Do you have required documentation to support the leave?

    Knowing whether a doctor note, school letter, or other proof is available speeds reviews and compliance. You can upload it or share when ready; HR will advise what is needed.

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