FMLA Request for Leave Form

FMLA Request for Leave Form

Boards & Governance, Planning & Launching | National

Sample FMLA Request form to be used if your school is required to offer FMLA (Family and Medical Leave Act) leave to your employees. If you are working with an employee leasing or payroll company they may have a form you may be required to use, however, if they do not, this sample document could be modified to be used at your school.

Downloads:

• FMLA Request For Leave Form Printable (PDF)
FMLA Request For Leave Form Printable (Word Doc)
FMLA Request For Leave Form Completable (PDF)