FMLA Leave Request Letter

Answer a few questions and we'll create your personalized letter.

Eligibility Check

We'll check whether federal FMLA or your state's family leave law applies to your situation.

State where you work

This determines which state family leave law supplements federal FMLA.

How many employees does your employer have?

50 or more employeesFewer than 50 employees

FMLA applies to employers with 50+ employees within 75 miles. Some states have broader coverage.

Months employed with this employer

FMLA requires at least 12 months of employment (need not be consecutive).

Approximate hours worked in the last 12 months

FMLA requires 1,250 hours. Full-time is approximately 2,080.