Leave of Absence Request and Approval Form

• Leave table for your jurisdiction with tick boxes: leave type, maximum length, who qualifies, paid days and the section of the Act
• Personal or unpaid leave option, and a company policy or collective agreement option
• Dates and supporting documents, with the jurisdiction's medical note rules where they apply
• Employee declaration and employer decision
• Benefits and seniority, and a return to work record
• Legal note on job-protected leave, reinstatement and privacy
• Fillable Word document and a print-ready PDF for each version (5 pages each)

Select your province, territory or federal jurisdiction before purchasing. Each version lists that jurisdiction’s job-protected leaves and cites its employment standards law. The federal version is for federally regulated private-sector employers under the Canada Labour Code. Not available for Quebec.

Small and growing Canadian businesses, and the owners, managers, payroll and HR professionals who handle leave requests.