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Request for Family Medical Leave

Last revision Last revision 09/01/2024
Formats FormatsWord and PDF
Size Size1 page
Fill out the template

Last revisionLast revision: 09/01/2024

FormatsAvailable formats: Word and PDF

SizeSize: 1 page

Fill out the template

The Family Leave Request Letter is a letter used by an employee to request family leave due to close relative's ill health or other serious issues involving close relative. The employee will use this letter to take some time off from work to care for a close relative who has is sufferings from:

(i) mental or physical illness, accident or injury, including to fully recover from any illness or injury;

(ii) elective surgeries such as organ or blood donation;

(iii) need for preventative medical care or medical diagnosis.

It is also used to attend to other serious family function, such as the burial of a spouse or other .

An employee may make this leave request orally or in writing. However, it is better to send a formal written request is required for proper documentation. This document will form part of the Human Resources file on the employee's absences at work. It shows the reason and duration of the sick leave. Some employers would prefer a written leave request. However, the employee must consult the Human Resources manager to ascertain the most suitable format for the leave request.

This document is should not be used when an employee is ill, injured, or is advised by a medical professional to take some time off from work to rest for health reasons, as the Sick Leave Request Letter is available for that purpose.

How to use this document

In this document, information, such as the reason for the leave, the leave period, and the contact details of employee requesting the leave is requires. Depending on the reason for this leave request, the employee may also enclose their close relative's medical report to support this application.

After completing the document, it should be printed and signed by the employee sending this letter. The signed letter can be sent either in a letter form or via email to the employer or the required to handle leave requests in the organization such as the human resources officer, the employee's supervisor, or any other officer at the organization.

Applicable law

There is no law regulating family medical leaves. However, the Labour Act 2004 recognizes regulates employment contracts.

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