Family and Medical Leave Sample Letters

For your convenience, here are the sample letters in Word format.

1. Employee Not FML Eligible - For All FML Requests except PDL 
2. Employee FML Eligible but Leave Entitlement Exhausted - For All FML Requests except PDL 
3. Employee FML Eligible - For Leave for Employee's Serious Health Condition 
4. Employee FML Eligible - For Leave for Family Member's Serious Health Condition 
5. Employee FML Eligible - For Military Caregiver Leave 
6. Employee FML Eligible - For Qualifying Exigency Leave 
7. Employee FML Eligible - For Parental Leave (when Employee is not Birth Mother) 
8. Employee FML Eligible - For Combined PDL and Parental Leave 
9. Employee Not FML Eligible - For Requests for PDL only 
10. Employee FML  Eligible but Leave Entitlement Exhausted - For Requests for PDL only 
11. Employee  FML Eligible - For Requests Limited to PDL 
12. Certification and/or Declaration Not Received - For all FML Leaves 
13. Certification Incomplete or Insufficient - For all FML Leaves 
14. Designation Letter - For All Approved and Denied FML Requests except Approved Requests for Combined PDL & Parental Leave 
15. Designation Letter - For Approved Combined PDL and Parental Leave 
16. PDL Confirmation Letter - Employee Not FML Eligible or Employee FML Eligible but Leave Entitlement Exhausted 
17. Letter for Change in End Date of PDL - For Approved Combined PDL and Parental Leave 
18. Recertification - For Leave for Employee' or Family Member's Serious Health Condition