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Please be advised that I hereby request an FMLA leave for a period of (number of weeks) in connection with my serious health condition. The leave is to start on (date). Attached is my medical note reflecting the need for FMLA leave. Please let me know whether you approve this leave at your earliest convenience.
If you give unequivocal notice of intent not to return to work to their company, the employer's obligations under FMLA to maintain benefits (subject to COBRA requirements) and to restore you to an equivalent position cease.
Your employer may have additional questions if they are not sure whether FMLA applies to your situation. What you could say: If you need leave to care for your parent after surgery: ?My father will have surgery next month, and I will need leave to care for him after he is released.?
Dear (Supervisor / HR Manager): Please be advised that I hereby request an FMLA leave for a period of (number of weeks) in connection with my serious health condition. The leave is to start on (date). Attached is my medical note reflecting the need for FMLA leave.
How Do I Request FMLA Leave? To take FMLA leave, you must provide your employer with appropriate notice. If you know in advance that you will need FMLA leave (for example, if you are planning to have surgery or you are pregnant), you must give your employer at least 30 days advance notice.