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Employee Request Form for Emergency Federal Leave Now Available

March 31, 2020 • April Mabry

Employee Request Form for Emergency Federal Leave Now Available

Editor’s note: The sample leave request form was updated on April 6, 2020 to include IRS guidance for documenting FFCRA leave.

An employee request form for emergency paid sick leave and expanded family and medical leave can be found in the HR Library.

The new form can be used when an employee’s request for leave falls under the Families First Coronavirus Response Act (FFCRA). Employee entitlement to the new leave begins on April 1, 2020. The new form documents:

  • Reason for leave
  • Duration of leave
  • Employee’s choice of leave during the absence
  • Employer’s choice to allow employees to use accrued paid leave to “top off” 2/3 pay provided by the Act

For more information, check out the following resources:


April Mabry is an assistant director at TASB HR Services. Send April an email at april.mabry@tasb.org.


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Tagged: Compensation, "Family and medical leave", FMLA, Leave