Leave of Absence Form

Purpose: 

To be filled out by employees when they are requesting extended time away from the job

Regulation: 
Policy: 

Measurement:

  1. When an employee wants to leave their position for >30 days the LOA form is required to be completed, submitted to administrator, approved and submitted to the proper HR representative

Process:

  1. Download and have the employee complete the following form entirely:
    Request for Leave of Absence Form - Non-FMLA.pdf
  2. Contact HR to inform them of a potential LOA
  3. Review the completed form from the employee to ensure it's complete and work with HR on next steps reviewing the form together.