FMLA Leave Request Letter
Request leave under the Family and Medical Leave Act for your own serious health condition, to care for a family member, for the birth or placement of a child, or for a military-related qualifying exigency. Includes your state's specific family leave law, job protection rights, and health insurance continuation requirements.
Statute of Limitations Warning
Legal deadlines apply to your claim. You lose your right to act if you wait too long. Send notice as soon as possible.
Why this letter works:
- Cites the exact law: Automatically applies the correct state and federal statutes to your situation.
- Sets a firm deadline: Legally compels a response within the required statutory timeframe.
- Creates a paper trail: Designed to serve as Exhibit A if you need to escalate to an agency or court.
Answer a few questions and we'll create your personalized letter.
New here? Read the full guide on family and medical leave (fmla) first.
One-time price:$19Paid once at the end. No subscription.
Your Action Plan
This is the final formal demand before litigation.
Download your personalized PDF immediately after purchase and send it.
Your letter includes a firm deadline. Do not engage in informal text messages during this time.
If they miss the deadline, you have completed the required out-of-court steps. Hand this complete paper trail to a local attorney for litigation.
Eligibility Check
We'll check whether federal FMLA or your state's family leave law applies to your situation.
This determines which state family leave law supplements federal FMLA.
FMLA applies to employers with 50+ employees within 75 miles. Some states have broader coverage.
FMLA requires at least 12 months of employment (need not be consecutive).
FMLA requires 1,250 hours. Full-time is approximately 2,080.
Before you start
What exactly do I get, and when?
A personalized PDF letter, written around the statute that applies to your situation, with the deadline and the consequence spelled out. It downloads the moment payment confirms, back here on commoner-law.com — there is no waiting period and no account to create. You can also add certified mail at checkout and we will send the physical letter for you.
How much is it?
$19, once. Not a subscription, and nothing is charged until you complete payment on Stripe at the end of the wizard. Any add-ons you select show their own price before you pay.
Is this legal advice?
This tool creates a leave request letter for self-help purposes. It is not legal advice and does not replace consultation with a licensed attorney. FMLA eligibility depends on multiple factors including employer size, length of employment, and hours worked. State family leave laws may provide additional or broader protections. If you are unsure whether you are eligible, consult an employment attorney or contact the DOL Wage and Hour Division.
What if I need to change something afterwards?
Tell us and we will either adjust the letter and send you the updated version at no cost, or refund you in full — your choice. If we can’t deliver what you paid for, the refund is automatic. Full terms are on our promise page.
Do I have to pay to know if I have a case?
No. The rights encyclopedia on this site is free and cites the same primary sources the letter does. Read the relevant guide first — plenty of situations are resolved by a phone call to a free statutory body, and where one exists we say so.