Free Leave of Absence Forms

What Is a Leave of Absence Form?

A Leave of Absence Form is a document that should be completed by a worker and submitted to their employer to request a release from work for a specific period.

Alternate Names:

  • Leave of Absence Request Form;
  • Leave of Absence Letter.

The regulation for granting a leave of absence from work is determined by the Family and Medical Leave Act (FMLA). According to this act, employers must allow their workers to take outstanding leave to care for a newborn or adopted child, a sick family member, or because of the worker's illness. The entity should keep the employment of these individuals for the required term. Workers can request 12 workweeks of unpaid release from work every 12 months, and for this purpose, they should complete an Unpaid Leave of Absence Form.

The described rules apply to:

  1. Workers who have at least 12 months experience in the organization, and have worked at least 1250 hours during this period.
  2. Entities with the number of workers equal to or more than 50.

Leave of Absence Form Types

How Do I Write a Leave of Absence?

A Leave of Absence Form usually consists of two parts: half of the form is completed by the employee and the other half is done by the employer. Information required from the employee includes the following:

  1. Information about the worker. The applicant should enter their name, address, phone number, Social Security number, department, and position in the organization.
  2. Absence information. Specify if it is a new request or an update to an existing one.
  3. Type of leave. Indicate if a long-term or periodic release from work is required.
  4. Reasons for leave. Enter a relevant cause for your appeal. The applicant should note if this reason is one of the rules stated by the FMLA. If you must provide care for a family member, specify their relationship to you. It can only be your son, daughter, spouse, or parent. The applicant should specify if an FMLA family or medical leave has already been successfully requested in the past 12 months. The applicant can specify other reasons to leave, such as a personal (non-medical) reason, work-related, or military leave.
  5. Dates of the requested leave. Enter the start and end dates of the absence. If the applicant requires an extension of their existing leave, they should provide an explanation and enter the type of prior petition.
  6. Leave of absence pay categories. The applicant should provide details about their available vacation, medical, and parental leave, enter the number of hours and dates regarding each one. The applicant can request to employ their unutilized leave categories and thus reduce the number of unpaid days.
  7. Signature. The applicant must sign the form and enter the date of completion.

This form usually contains a space that should be filled in by an authorized officer of the organization. They should indicate their solution regarding this request: specify if it is approved or denied. In the case of disapproval, an authorized officer must explain this decision. This individual should sign the form and enter the date of completion.

How to Take a Paid Leave of Absence From Work?

If a worker requests a release from work to take care of their newborn child, entities are not obliged to grant them a paid leave. Organizations should do it under the requirements established by state law only. The states which have effective laws, granting parental leave, are California, Rhode Island, New York, New Jersey, and Washington.

If a worker wishes to apply for a paid release from work for other reasons, they can request it according to the leave of absence policy established in their company. They can find this regulation in the handbook of their company or in their employment contract. For this purpose, a worker should fill in a Paid Leave of Absence Form.

Can a Leave of Absence Be Denied?

Entities are obliged to approve a request for a release from work if their workers have such rights under the FMLA or state law. In other cases, an entity may refuse to grant their worker medical leave, which may cause difficulties for their business. This refusal is allowed in the following cases:

  1. The worker is unable to specify the date of return to the workplace.
  2. The entity is unable to find a temporary replacement for this worker due to the specific nature of the work performed by this individual.
  3. The duration or frequency of the requested leave can cause significant expenses for the entity.

Haven't found the form you are looking for? Take a look at these related forms:

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Documents:

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This document is used for requesting a leave of absence in Sacramento, California. It provides a formal way to request time off from work or school.

This is a document which is supposed to be filled out by a government employee in order to request time off from working duty. The application is issued by the U.S. Office of Personnel Management (OPM).

This document is an employee application for paid family leave benefits in Inyo County, California. It is used for employees who need to take time off from work to care for a family member and receive financial assistance during that time.

This document for reporting continuous absence, exhaustion of paid leave, or lack of communication by an employee in West Virginia. It provides a sample template to document and address these issues.

This document is used for applying for family and medical leave in the state of Utah. It allows eligible employees to take time off from work to care for themselves or their family members during times of medical need.

This form is used for requesting a period of leave without pay from your employer. It allows employees to temporarily suspend their regular salary and benefits while taking time off from work.

This Form is used for requesting a leave of absence from Diamond Healthcare Staffing.

This Form is used for requesting Family and Medical Leave (FML) from Arlington Public Schools.

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This form is used to request permission for temporary military leave. This form can be used to request an emergency leave, a vacation, travel, or an extended pass.

This form is used for requesting and obtaining authorization for a leave of absence for commissioned officers in the Public Health Service.

This Form is used for notifying employees in Arkansas about their rights under the Family and Medical Leave Act (FMLA). It allows employers to designate an employee's leave as FMLA-qualifying and provide them with the necessary information.

This form is used for requesting a leave of absence under the Family and Medical Leave Act (FMLA) in the state of Nevada.

This document is used for recording administrative leave for active military duty in Maryland. It helps to keep track of the leave taken by military personnel serving in Maryland.

This type of document is used to notify an employee in Florida that their Family and Medical Leave Act (FMLA) will be expiring.

This document is an FMLA (Family and Medical Leave Act) approval letter specific to the state of Florida. It is used to notify an employee that their request for leave has been approved under this federal law.

This Form is used for requesting Emergency Family-Medical Leave (EFML) in the state of Indiana.

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This Form is used for applying for a leave of absence under the Families First Coronavirus Response Act (FFCRA) in North Carolina. It allows individuals to request leave due to COVID-19 related reasons.

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