AI FMLA request letter
Request family and medical leave in writing: state the reason, the dates, and the schedule (continuous or intermittent) in a formal letter your HR department can act on.
Build your request
Draft savedPick the leave reason, the schedule, and the start date.
FMLA self-check (plain English)
Answer these three questions in your own words. They are the basics people run into with FMLA. Your answers are collected into the draft so HR has the context — this tool does not assess whether you qualify. Only HR can confirm eligibility for your situation.
Intermittent leave: describe the schedule you need below (for example, two days per week for treatment). The letter will state the pattern exactly as you describe it.
0 characters · Plain facts only: what the leave is for, what your doctor or situation requires, and the schedule you need. No diagnosis detail beyond what you are comfortable sharing.
0 characters · One or two sentences is enough.
Shortcut Ctrl+Enter · Autosaves as you type
Your letter
1. Answer the three self-check questions
2. Pick the leave reason, schedule, and dates
3. Hit Generate
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Real situations this fits
- You need time off for your own serious health condition: surgery, treatment, or recovery your doctor can document
- A spouse, child, or parent has a serious health condition and you need leave to provide care
- You are having or adopting a child and want the request in writing with clear dates
- You need a qualifying military exigency leave and want the request stated plainly for the file
- The leave is not one block of time: you need intermittent days or a reduced schedule for ongoing treatment
What actually matters
Put the request in writing
Verbal leave requests get misremembered. A written letter states the reason, the start date, and the expected return date in one document HR can file. Date it, keep a copy, and note how you delivered it. The letter is your record that notice was given.
State the schedule plainly
Continuous leave is one block of time. Intermittent leave is separate blocks or a reduced schedule, such as two days a week for treatment. If you need intermittent leave, describe the pattern exactly: the days, the hours, and what drives the schedule. Vague wording invites disputes later.
Answer the self-check honestly
The three questions above (time employed, hours worked, employer size) are the basics people run into with FMLA. Your answers go into the draft as your own statements, so HR has the context up front. This tool never decides whether you qualify; only HR can confirm that.
Certification is separate from the letter
Employers often ask for medical certification from a health care provider to support the leave. The letter is the request; the certification is the proof. Mention in the letter that you can provide certification if HR requires it, and get the paperwork from your provider promptly.
FAQ
How do I write an FMLA request letter?
State that you are requesting leave under the Family and Medical Leave Act, give the reason in plain terms, state the start date and expected return date, say whether the leave is continuous or intermittent, and note how you can be reached during leave. This tool drafts that letter from your facts. It is general information, not legal advice.
Do I qualify for FMLA leave?
This tool does not assess eligibility. The usual questions are whether you have worked for the employer for 12 months, worked 1,250 hours in the prior 12 months, and whether the employer has 50 employees within 75 miles of your worksite. Only your HR department can confirm eligibility for your situation. The self-check above collects your answers for the draft; it is not a finding.
Can I take FMLA leave intermittently?
Intermittent leave means taking leave in separate blocks or working a reduced schedule instead of one continuous block. Your letter should describe the exact schedule you need, based on what your health care provider supports. Use the intermittent mode above to draft that version of the letter.
How much notice do I need to give for FMLA leave?
When the need is foreseeable, employees are generally expected to give 30 days' notice; when it is not foreseeable, notice is expected as soon as practicable. Check your employer's policy and HR for the exact process. A written request with a date on it protects you either way.
What does my employer need from my doctor?
Employers commonly require medical certification from a health care provider to support FMLA leave. The letter is the request; the certification is the proof. Say in the letter that you can provide certification if HR requires it, and get the paperwork from your provider promptly. HR will usually supply the form they want used.
Should I talk to an employment lawyer about my leave?
If your leave was denied, your job was affected while you were out, or you were treated differently after requesting leave, talking to an employment attorney early is worth the consultation. This tool drafts the request letter from your facts; it does not assess your rights and it is not a substitute for counsel.
Is this legal advice?
No. This tool drafts a formal request letter from the facts you enter. It does not tell you whether you are eligible for FMLA leave, whether your request will be approved, or what outcome to expect. Review the draft with an HR representative or an employment attorney before sending.