Free Leave of Absence Forms

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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. 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:

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

See below to check out our library of Leave of Absence forms.

How Do I Write a Leave of Absence?

A Leave of Absence usually consists of two parts. This part must be completed by the employee:

  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.
  5. The applicant can specify other reasons to leave, such as a personal (non-medical) reason, work-related, or military leave.
  6. 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 the prior petition.
  7. 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.
  8. 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 a medical leave, which may cause difficulties for their business. This refusal is allowed in the following cases:

  • The worker is unable to specify the date of return to the workplace;
  • The entity is unable to find a temporary replacement to this worker due to the specific nature of the work performed by this individual;
  • 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:

Documents

19

"Family and Medical Leave Forms - Archdiocese of Los Angeles" - Los Angeles, California

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"Application for Leave of Absence - Gratia Christian College"

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"Request for Leave of Absence - Mckenzie Management"

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"Absentee Form"

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Absence Report Template