LETTER
EXPLAINING FAMILY AND MEDICAL LEAVE
[DATE]
Dear RECIPIENT NAME
Good day!
I would like to request FMLA leave for NUMBER of days of absence from START DATE to [END
DATE) due to my current health condition. have attached with this letter a medical notice signed by
doctor. Please let me know if you require additional documents. If for any valid reason you should
find that do not qualify for an FMLA leave, please notify me at the earliest.
Thank you very much for considering my request.
Regards
[YOUR SIGNATURE]
[YOUR NAME]
