Leave of Absence Request

The purpose of this Leave of Absence request form is to provide employees with a clear and consistent process for requesting a prolonged period of time away from work for qualifying personal, medical, family, military, or other approved reasons. This form helps ensure timely communication, proper documentation, and compliance with company policies and applicable leave laws while supporting employees during their time away from work. It also assists the company in coordinating operational needs, benefits administration, and return-to-work planning.

Resources:

• Employee Guide for Leave of Absence
• Employee Leave of Absence Checklist
• Foreseeable vs. Non-Foreseeable Leave of Absences
• FMLA Employee Guide

Please complete the form fully with all known details. The People Department will receive the form and reach out to you and your supervisor via email within 1 business day to confirm your request, ask any additional questions needed, and provide other information necessary for your leave.