Template · Time off and attendance

Leave request form

By TapTalent Editorial TeamUpdated

In short

A leave request form is the document an employee uses to ask for time off and a manager uses to approve or deny it. It records the type of leave, dates and hours, the balance available, coverage arrangements and the decision. This template works as a time off request form for PTO, vacation, sick and unpaid leave, with notes on when a request triggers FMLA or state leave rights.

Leave Request Form template

Leave Request Form

Submit to your manager at least [number] days before planned leave, or as soon as practical for unplanned absences. For your own serious health condition, a family member's serious health condition, the birth or placement of a child, or military family needs, also contact HR at [HR Email]: you may have rights to job-protected leave under the FMLA or state law.

Employee details

Employee name
Employee ID
Job title
Department / team
Location / site
Manager
Date of request

Leave requested

Type of leave
Paid time off (PTO)VacationSick leave (own illness or care)Personal dayBereavementJury duty or witness dutyVoting timeMilitary leaveUnpaid personal leaveOther: specify below
Other / details (optional; you do not need to share medical details)
First day of leave
Last day of leave
Date returning to work
Partial day: start time to end time
Total working days requested
Total hours requested
Shifts affected (list dates and shift times)
Is this request related to your own or a family member's serious health condition, pregnancy, a new child, or a family member's military service?
NoYes: HR will contact me about leave rightsPrefer to discuss with HR

Coverage and handover

Person covering my work or shifts (if arranged)
Shift swaps agreed (attach approved swap form if applicable)
Work to be handed over or rescheduled
Reachable during leave for urgent questions
NoYes, by email onlyYes, by phone

Employee acknowledgment

I understand this request is not approved until I receive manager approval, except where leave is protected by law.
I understand that if my balance is not enough, the remaining hours may be unpaid or require approval under the leave policy.
Employee signature
Date

Manager decision

Date received
Decision
ApprovedApproved with changes (see notes)DeniedReferred to HR (possible protected leave)
If changed or denied: reason and alternative dates offered
Schedule updated
Manager signature
Date of decision

HR / payroll use

Leave balance before request (hours)
Hours to be paid
Hours unpaid
Balance after request (hours)
Pay code
Designated as FMLA or state protected leave
NoYes: notices issuedPending: eligibility notice sent
Entered in payroll / timekeeping by
Date entered

How to use this template

  1. Set your advance-notice rule in the form intro, for example two weeks for planned vacation, and match it to your written PTO policy.
  2. Employee completes the details, leave type, dates and hours, and lists any shifts affected.
  3. Employee arranges coverage where the team allows it and attaches any approved shift swap.
  4. Manager checks the team calendar and decides within a set time, typically 2 to 3 business days, recording a reason and alternative dates if the request is denied.
  5. If the request may involve a serious health condition, a new child or military family needs, the manager refers it to HR instead of approving or denying it.
  6. HR or payroll confirms the balance, enters the hours with the right pay code, and files the form.

When to use a PTO request form

Use the form for any time off the employee plans or knows about: vacation, personal days, scheduled medical appointments, jury duty. For same-day sick calls, the form usually gets completed afterward so the absence is recorded with the right pay code. The point is a consistent record. Every request, approval, denial and balance change lives in one place, so payroll pays the right hours and nobody argues later about whether Friday was approved.

Set the rules for how far ahead to ask, how requests are prioritized and how balances accrue in your PTO policy template. This form should mirror that policy, not invent its own rules. For definitions of the leave types, see our glossary entry on paid time off.

Requests that are not just a manager's decision

Some leave requests are protected by law, and a manager who denies them can create a claim even with good intentions. The common ones:

  • FMLA. Employers with 50 or more employees must give eligible employees (12 months of service, 1,250 hours in the last 12 months, at a site with 50 employees within 75 miles) up to 12 weeks of unpaid, job-protected leave a year for their own serious health condition, a family member's, the birth or placement of a child, and qualifying military exigencies, plus up to 26 weeks for military caregiver leave. Once the employer knows a request may qualify, it generally must send an eligibility notice within five business days. The employee does not have to say "FMLA" for the obligation to start.
  • State paid sick leave and family leave. Many states and cities require paid sick leave, and a growing number run paid family and medical leave programs. These often cover smaller employers and shorter tenure than FMLA.
  • ADA. Leave can be a reasonable accommodation for a disability, even when FMLA does not apply.
  • Pregnancy. The Pregnant Workers Fairness Act requires reasonable accommodation for known limitations related to pregnancy, which can include time off.
  • Military, jury and voting leave. USERRA protects military service leave, and most states protect jury duty and, in many cases, time to vote.

That is why the form has a referral option. Managers should send these to HR rather than decide them. Use the FMLA leave request form for that process. Rules differ by state and city, so check where each employee works.

Approving and denying fairly

Decide requests quickly and in the same way for everyone. A common rule is first come, first served for vacation, with a written blackout calendar for peak periods (year-end close, holiday retail, the first two weeks of a new contact center campaign) published at the start of the year. Seniority-based systems are still common in unionized workplaces; follow the agreement.

When you deny a request, put the reason on the form and offer alternative dates. "Two agents on the team are already off that week" is a fair reason. A pattern where some employees are approved and others are not, with no documented reason, is what turns a scheduling decision into a discrimination complaint.

Never ask for medical details on a general request form. A manager needs to know the dates, not the diagnosis. If certification is needed, HR handles it through the protected leave process.

Time off in shift-based and high-volume teams

In a contact center, warehouse or hospital unit, every hour off affects coverage. Workforce planners usually set a daily allowance: the number of people who can be off in each interval or shift without missing service levels. A 200-agent operation might allow 8% shrinkage for planned time off on a normal weekday and 3% in peak weeks. Requests within the allowance are approved automatically; requests outside it go to a supervisor.

Publish the allowance so staff can see open slots before they ask. That cuts the volume of requests that will be denied and the frustration that follows. Track approved leave and unplanned absences in one place, such as an attendance tracker template or an attendance management tool, so you can see whether planned time off is being used and where unplanned absence is replacing it.

Common mistakes with vacation request forms

  • No balance check before approval. Approving 40 hours for someone with 16 hours available creates a payroll problem and an awkward conversation.
  • Counting days, not hours. For part-time staff and 10- or 12-hour shifts, a "day" means different things. Record hours.
  • Paper forms that never reach payroll. If approvals live in a manager's drawer, payroll will pay from the timesheet and balances drift.
  • Treating protected leave as discretionary. Denying or counting protected absences against attendance points can violate FMLA and state law.
  • Use-it-or-lose-it policies in states that ban them. California, for example, treats earned vacation as wages that cannot be forfeited. Check your state before setting carryover rules.

Frequently asked questions

What should a leave application form include?

Employee details, type of leave, start and end dates, total hours, shifts affected, coverage arrangements, a signed acknowledgment, the manager's decision with reasons, and a payroll section for balances and pay codes.

How far in advance should employees submit a time off request form?

Most employers ask for two to four weeks for vacation and 24 to 48 hours for short personal time. Set the rule in your PTO policy. For foreseeable FMLA leave, employees generally must give 30 days' notice when practicable.

Can an employer deny a PTO request?

Yes, for ordinary vacation or personal time, based on business needs and applied consistently. Leave protected by law, such as FMLA, state paid sick leave or ADA accommodation, cannot simply be denied.

Should employees give a reason on a vacation request form?

For vacation and PTO, no reason is needed. For sick leave, asking for medical details on a general form is not good practice. If the leave may be protected, HR follows the formal certification process.

Is a PTO request form different from an FMLA request form?

Yes. A PTO request is a scheduling request the manager approves. An FMLA request starts a legal process with eligibility notices, possible medical certification and job protection, and HR should manage it.