Sample Medical Leave Of Absence Letter

If you use this simple sick leave letter you don t require to produce any confirmation letter from physician hence it can be produce just as a written statement.

Sample medical leave of absence letter. If you re handing in a printed letter opt for a handwritten signature. Sample letters for medical leave requests. Below are sample medical leave of absence letters. We ve put together a few different templates that you could follow when requesting a leave of absence.

Three of the most common reasons to submit a letter to request time off from work in the form of a medical leave of absence are surgery diagnosis of a serious illness or a chronic condition that may require intermittent leave. I am requesting that you grant mr. Ross i am writing on behalf of david graham my patient and your employee. Use the letters in this section if you need to request medical leave but are not eligible for family medical leave fml.

If there are any documents enclosed such as a letter from a doctor or medical records only copies should be sent and never original documents. Graham a medical leave of absence from his work at oceanside corporation due to a confirmed case of laryngitis coupled with swelling of the throat and extreme irritation. I will have my procedure on september 15 2020 and i intend to the office on october 6 2020. I am writing to request for three weeks of medical leave to have minor surgery done on my lower back.

Your name and signature. Certified mail should be used to send the letter in order for the employee to have proof that they sent the letter within the prescribed time. For medical leave to care for a sick family member. This type of medical leave letter is common among employees and it is often used by them.