How to Write an FMLA Letter to Employer: A Step-by-Step Guide

Understanding the FMLA Letter to Employer

The Family and Medical Leave Act (FMLA) allows eligible employees to take unpaid leave for specific family and medical reasons while maintaining job protection. Writing an FMLA letter to your employer is a formal way to request this leave. The letter should clearly state your intention to take leave under the FMLA and include essential details about your situation.

Key components of the FMLA letter include:

  • Dates of Leave: Specify the start and end dates for your requested leave.
  • Reason for Leave: Briefly explain the qualifying reason, such as a serious health condition or caring for a family member.
  • Certification: Indicate that a healthcare provider has certified your need for leave.
  • Request for Approval: Clearly request approval for your leave and offer to provide additional documentation if necessary.

Key Elements of an FMLA Letter

When composing your FMLA letter, it is crucial to include specific elements to ensure clarity and compliance with the law. Here are the essential components:

  • Your Contact Information: Include your name, address, phone number, and email at the top of the letter.
  • Employer's Contact Information: Address the letter to your supervisor or HR department, including their name and title.
  • Date: Include the date you are writing the letter.
  • Subject Line: Clearly state that the letter is a request for FMLA leave.
  • Body of the Letter: Provide details about your leave request, including the reason and any relevant dates.
  • Closing: End with a polite closing statement and your signature.

Sample FMLA Letter to Employer

Here is a sample FMLA letter to assist you in drafting your own:

[Your Name]

[Your Address]

[City, State, Zip Code]

[Email Address]

[Phone Number]

[Date]

[Employer's Name]

[Company Name]

[Company Address]

[City, State, Zip Code]

Subject: Request for FMLA Leave

Dear [Employer's Name],

I am writing to formally request leave under the Family and Medical Leave Act (FMLA) due to [briefly explain the reason, e.g., my own serious health condition]. I would like to request leave starting from [start date] to [end date].

I have obtained certification from my healthcare provider, which I am happy to provide upon request. Please let me know if you need any additional information to process my request.

Thank you for your understanding.

Sincerely,

[Your Name]

Steps to Complete an FMLA Letter

To effectively write your FMLA letter, follow these steps:

  • Gather Information: Collect all necessary details, including your medical condition, dates of leave, and any required documentation from your healthcare provider.
  • Draft the Letter: Use the sample provided as a guide, ensuring you personalize it to reflect your situation.
  • Review and Edit: Check for clarity, grammar, and completeness. Ensure all essential elements are included.
  • Submit the Letter: Deliver the letter to your employer through the preferred method, whether by email or printed copy.

Common Reasons for FMLA Leave

Employees may request FMLA leave for various reasons. Understanding these can help you articulate your request effectively:

  • Personal Health Issues: Serious health conditions that require prolonged treatment or recovery.
  • Family Member's Health: Caring for a spouse, child, or parent with a serious health condition.
  • Childbirth or Adoption: Taking time off for the birth of a child or to adopt a child.

Legal Considerations for FMLA Leave

FMLA leave is protected under federal law, which means employers cannot retaliate against employees for taking leave. However, there are specific eligibility criteria that must be met:

  • Length of Employment: Employees must have worked for their employer for at least twelve months.
  • Hours Worked: Employees must have completed at least one thousand two hundred fifty hours of work in the twelve months prior to the leave.
  • Employer Size: The employer must have at least fifty employees within a seventy-five-mile radius.

Documentation Requirements for FMLA Leave

Employers may require documentation to support your FMLA leave request. This may include:

  • Medical Certification: A form completed by your healthcare provider detailing your condition and the need for leave.
  • Proof of Relationship: If caring for a family member, documentation may be needed to establish the relationship.

Submitting Your FMLA Letter

Once you have completed your FMLA letter, consider the following submission methods:

  • Email: Sending the letter via email can provide a quick and documented way to submit your request.
  • In-Person: Handing the letter directly to your supervisor or HR can ensure it is received promptly.
  • Certified Mail: For added security, sending the letter via certified mail can provide proof of delivery.
By signNow's Team
By signNow's Team
August 28, 2025
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