A “Sample Letter To Request Family Medical Leave” is a template. People use it to ask their employer for time off. They need it for their own or a family member’s serious health issues.
Need to write such a letter? Don’t worry. We’ve got you covered.
We will share letter samples here. These samples will make your writing easy. Use them as a guide.
Sample Letter To Request Family Medical Leave
[Your Name]
[Your Address]
[Your Phone Number]
[Your Email Address]
[Date]
[Employer’s Name]
[Employer’s Title]
[Company Name]
[Company Address]
Subject: Request for Family Medical Leave
Dear [Employer’s Name],
I am writing to request a family medical leave of absence, starting on [Start Date] and ending on [End Date]. I need to care for my [Relationship to family member, e.g., mother/father/child] who is suffering from [Briefly describe medical condition].
[Family member’s name] requires my assistance with [Specific care duties, e.g., doctor’s appointments, daily living activities, medication]. I have attached supporting documentation from [Doctor’s Name] regarding [Family member’s name]’s medical condition.
I understand my responsibilities and will do my best to minimize any disruption to my work. I will be available by phone and email at [Your Phone Number] and [Your Email Address] if needed. I have also [Mention any steps taken to prepare for your absence, e.g., completed urgent tasks, trained colleagues].
I am requesting leave under the Family and Medical Leave Act (FMLA) and would appreciate it if you could confirm my eligibility.
Thank you for considering my request.
Sincerely,
[Your Signature]
[Your Typed Name]
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How to Write Letter To Request Family Medical Leave
1. Crafting a Compelling Subject Line
The subject line is your first impression. It should be concise and instantly inform your employer of the letter’s purpose. Avoid ambiguity; be direct.
- Example: “Request for Family Medical Leave – [Your Name]”
- Alternatively, use: “FMLA Leave Request – [Your Last Name], [Start Date]” to preemptively provide key details.
2. Initiate With a Professional Salutation
Begin with a formal address to maintain decorum. Consider your relationship with the recipient.
- If you know your manager well: “Dear [Manager’s First Name] [Manager’s Last Name],”
- For a more formal approach or if uncertain: “Dear Mr./Ms./Mx. [Manager’s Last Name],”
- In rare cases, if unsure of the recipient: “To Whom It May Concern,” (though strive to avoid this).
3. Articulating the Reason for Your Absence
Clearly and succinctly state the reason for requesting family medical leave. Deference to privacy is acceptable, but vagueness can breed suspicion.
- Specify whom you will be caring for (child, spouse, parent).
- Briefly describe the medical condition requiring your attention, without divulging excessively personal details.
- Example: “I am writing to request family medical leave to care for my [relationship] who is experiencing a serious health condition.”
4. Detailing the Duration of Your Leave
Provide a clear timeline for your anticipated absence. Even an estimate is crucial for workforce planning.
- State the anticipated start and end dates of your leave.
- If the duration is uncertain, provide an estimated range (e.g., “approximately four to six weeks”).
- Mention if the leave will be intermittent or continuous.
- Include a sentence indicating your willingness to provide updates as the situation evolves.
5. Reaffirming Your Commitment and Availability
Reassure your employer of your ongoing commitment to your role, even while on leave. This can assuage anxieties about workflow disruption.
- Express your intention to stay connected, if appropriate and feasible.
- Offer to assist in transitioning your responsibilities before your leave commences.
- Example: “I am committed to ensuring a smooth handover of my current projects and am available to discuss this further prior to my leave.”
6. Invoking FMLA and Providing Necessary Documentation
Explicitly mention your intention to utilize Family and Medical Leave Act (FMLA) benefits. This triggers specific employer obligations.
- State that you are requesting leave under the FMLA.
- Indicate that you will provide the necessary medical certification from a healthcare provider.
- Specify when you anticipate submitting the certification.
- Optionally, attach any preliminary documentation you have available.
7. Concluding With Gratitude and Contact Information
End the letter on a gracious note, expressing appreciation for your employer’s understanding. Include your contact information for easy communication.
- Use a professional closing: “Sincerely,” “Respectfully,” or “Best regards,”
- Include your full name.
- Provide your phone number and email address.
- Express gratitude for their consideration. Example: “Thank you for your understanding and support during this challenging time.”
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Frequently Asked Questions: Requesting Family Medical Leave
Understanding the process of requesting Family Medical Leave (FML) can be complex. This FAQ section provides answers to common questions regarding the creation and submission of a formal request letter.
What information should I include in my FML request letter?
Your letter should include your full name, employee ID (if applicable), your supervisor’s name, the reason for the leave, the anticipated start and end dates of the leave, and a statement confirming your intention to return to work after the leave period.
How far in advance should I submit my FML request letter?
It is generally recommended to submit your FML request letter at least 30 days in advance, if the need for leave is foreseeable. If the leave is unforeseeable, you should notify your employer as soon as practicable.
To whom should I address my FML request letter?
Address your FML request letter to your direct supervisor or the human resources department. Confirm the appropriate recipient according to your company’s policy.
Do I need to provide medical documentation with my FML request letter?
While not always required with the initial request, your employer may require medical certification from a healthcare provider to support your need for FML. Be prepared to provide this documentation if requested.
What should I do after submitting my FML request letter?
After submitting your letter, keep a copy for your records. Follow up with your supervisor or HR department to confirm receipt and discuss the next steps in the FML process.