5 Effective Samples of Email for FMLA Requests

5 effective samples of email for fmla requests

The Family and Medical Leave Act (FMLA) entitles eligible employees to take unpaid, job-protected leave for specified family and medical reasons. To request FMLA leave, employees must provide their employer with written notice. This notice can be in the form of a letter, email, or other written communication.


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An email requesting FMLA leave should include the following information:

  • Employee’s name
  • Employee’s job title
  • Employee’s department
  • Date of the request
  • Type of leave requested (e.g., maternity leave, paternity leave, medical leave)
  • Start date and end date of the leave
  • Reason for the leave
  • Contact information for the employee while on leave

The email should be sent to the employee’s supervisor or HR department. It is important to submit the request as soon as possible, as the employer may need time to process the request.

Effective FMLA Request Email Structures

1. Brief and Informative

Subject: FMLA Request for Leave

Dear [Manager’s Name],

I am writing to request a Family and Medical Leave Act (FMLA) leave of absence. I have been experiencing [brief health issue]. My doctor has recommended a leave of absence from [start date] to [end date]. I have enclosed a doctor’s note for your review.

Thank you for your consideration.

Sincerely,

[Your Name]

2. Detailed and Supportive

  • Subject: Request for FMLA Leave Due to [Condition]
  • Dear [Manager’s Name],
  • I am writing to request a leave of absence under the Family and Medical Leave Act (FMLA) due to my ongoing [condition]. As you know, I have been experiencing [symptoms] for the past [number] months.
  • My healthcare provider, [doctor’s name], has recommended a leave of absence from [start date] to [end date] to allow for treatment and recovery.
  • I have enclosed a doctor’s note providing details of my condition and the recommended leave of absence.
  • I understand the importance of my responsibilities and will make arrangements to delegate my duties while I am on leave.

3. With Previous FMLA Leave

Leave Request Start Date End Date Reason
Previous FMLA Leave [Start Date] [End Date] [Reason for Leave]
Current FMLA Leave [Start Date] [End Date] [Reason for Leave]

Subject: Request for Subsequent FMLA Leave

Dear [Manager’s Name],

I am writing to request a subsequent leave of absence under the Family and Medical Leave Act (FMLA). As you may recall, I previously took a leave of absence from [previous start date] to [previous end date] due to [previous reason for leave].

My condition has since worsened, and my doctor has recommended another leave of absence from [start date] to [end date]. I have enclosed a doctor’s note providing details of my current condition and the recommended leave of absence.

Thank you for your understanding and support.

Sincerely,

[Your Name]

4. With Request for Intermittent Leave

Subject: Request for Intermittent FMLA Leave

Dear [Manager’s Name],

I am writing to request intermittent leave under the Family and Medical Leave Act (FMLA). I have been experiencing [condition] for the past [number] months, which requires ongoing medical treatment.

My doctor has recommended that I take leave on a [frequency] basis to accommodate my medical appointments and recovery. I anticipate needing approximately [number] days of leave.

I will provide you with advance notice of my leave dates as soon as possible.

5. With Request for Reduced Schedule

Subject: Request for FMLA Leave – Reduced Schedule

Dear [Manager’s Name],

I am writing to request a leave of absence under the Family and Medical Leave Act (FMLA) in the form of a reduced schedule. As you know, I have been experiencing [condition] for the past [number] months.

My doctor has recommended that I reduce my work schedule from [current hours] to [reduced hours] per week from [start date] to [end date]. This will allow me to attend medical appointments and recover from my condition.

I have enclosed a doctor’s note providing details of my condition and the recommended reduction in schedule.

5 Effective FMLA Request Email Samples

Requesting Leave for a Serious Health Condition

Subject: Application for FMLA Leave

Dear [Manager’s Name],

I am writing this email to request a leave of absence under the Family and Medical Leave Act (FMLA) for a serious health condition. As you are aware, I have been experiencing [condition] for the past [duration], and my doctor has advised that I require [duration] weeks of leave to undergo necessary medical treatment and recover.

  • Details of the condition
  • Date the condition is expected to cause an absence from work
  • Expected return to work date
  • Supporting medical documentation from the doctor

Requesting Leave to Care for a Family Member

Subject: FMLA Leave Request for Family Care

Dear [Manager’s Name],

I am requesting a leave of absence under the Family and Medical Leave Act (FMLA) to care for my immediate family member, [family member’s name]. [Family member’s name] has been diagnosed with [condition] and requires my assistance with [specific needs].

  • Name and relationship of the family member
  • Details of the family member’s condition
  • Expected start and end dates of leave
  • Supporting medical documentation

Requesting Intermittent Leave

Subject: Request for Intermittent FMLA Leave

Dear [Manager’s Name],

I am writing to request an intermittent leave of absence under the Family and Medical Leave Act (FMLA) due to my ongoing medical condition, [condition]. This condition requires me to take [duration] of leave every [interval].

  • Details of the ongoing medical condition
  • Frequency and duration of requested leave
  • Expected dates of future absences
  • Medical documentation supporting the request

Requesting Reduced Work Schedule

Subject: Reduced Work Schedule Request Under FMLA

Dear [Manager’s Name],

I am writing to request a reduced work schedule under the Family and Medical Leave Act (FMLA) for a serious health condition that affects my ability to work full-time. My doctor has advised that I limit my working hours to [reduced hours] per day or week.

  • Details of the medical condition
  • Requested work schedule
  • Expected duration of the reduced schedule
  • Supporting medical documentation

Requesting Leave Extension

Subject: Extension of FMLA Leave

Dear [Manager’s Name],

I am currently on FMLA leave for [condition] and writing to request an extension of my leave for an additional [duration]. My current leave is scheduled to end on [end date], however, my doctor has determined that I need additional time to continue my treatment and recovery.

  • Reason for the extension
  • Expected return to work date
  • Updated supporting medical documentation

FMLa requests email templates

What is the best way to write an email to request FMLA leave?

An email requesting FMLA leave should be clear, concise, and professional. It should include the following information:

– Your name
– Your position
– The date you are requesting leave to begin
– The date you are requesting leave to end
– The reason for your leave
– Any supporting documentation you have, such as a doctor’s note
– State that you are requesting FMLA leave so that it is clear what you are requesting
– The date you expect to return to work
– Your contact information

FMLA requests email templates

How should I request an extension of my FMLA leave?

To request an extension of your FMLA leave, you should send a written request to your employer. The request should include the following information:

– Your name
– Your position
– The date your current FMLA leave is scheduled to end
– The date you are requesting your leave to be extended to
– The reason for your request
– Any supporting documentation you have, such as a doctor’s note
– Your contact information

FMLA requests email templates

What if my FMLA request is denied?

If your FMLA request is denied, you can appeal the decision. The appeal should be submitted to your employer in writing and should include the following information:

– Your name
– Your position
– The date your FMLA request was denied
– The reason for the denial
– Your reason for appealing the decision
– Any supporting documentation you have, such as a doctor’s note
– Your contact information

Thanks so much for taking the time to read through these examples! I hope they’ll help you get started with your own FMLA request. If you have any questions or need some additional help, feel free to reach out to an employment lawyer. And remember, I’ll be back with more tips and advice soon, so stop by again later.

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