FMLA Leave Request Letter

Subject: FMLA Leave Request - [Your Name]

Dear [HR Manager's Name/Manager's Name],

I am writing to formally request leave under the Family and Medical Leave Act (FMLA) beginning [Start Date].

Reason for Leave: [Choose one]
- My own serious health condition
- To care for [family member relationship] with a serious health condition
- Birth/adoption/foster placement of a child
- Qualifying military exigency

Anticipated Duration: [Estimated length of leave]

Type of Leave Requested: [Choose one]
- Continuous leave
- Intermittent leave
- Reduced schedule leave

I understand that I need to provide medical certification within 15 calendar days. I will submit the required documentation to HR as soon as possible.

During my absence, I am prepared to:
- Complete any pending critical tasks before my leave begins
- Provide detailed documentation for ongoing projects
- Be available for brief, essential communications if medically possible

Please provide me with:
- FMLA eligibility determination
- Rights and responsibilities notice
- Medical certification forms (if applicable)

I am committed to maintaining communication with HR regarding my return-to-work status. Please let me know if you need any additional information.

Sincerely,
[Your Name]
[Employee ID]
[Department]
[Date]