Request time off by sharing your dates and the reason.
HR template · 11 fields (8 required) · ~3 min for respondents to complete · Free plan · No credit card · Fully customizable
Set up your leave request form
Request time off by sharing your dates and the reason.
Use this for sick, family, bereavement and other leave. Collect only the reason category you need and keep any medical documents limited to what your policy requires.
The form separates phone number (optional), department, type of leave, leave start date into labeled questions. Review the choices and required fields for your organization before sharing it.
Best practices
Use this for sick, family, bereavement and other leave. Collect only the reason category you need and keep any medical documents limited to what your policy requires.
Customize the phone number (optional) and department questions to match your records and terminology.
Name the team that reviews responses and explain what happens after submission. A requested date, service or approval is not automatically confirmed.
Keep uploads limited to relevant supporting material. Use your approved private process for sensitive records and verify response access before sharing.
Every field, explained
Employee name (Name, required)
Email address (Email, required)
Phone number (optional) (Phone)
Department (Short text, required)
Type of leave (Dropdown, required)
Leave start date (Date, required)
Leave end date (Date, required)
Full or partial days? (Single choice, required) — For partial days, list the dates and hours in the details box.
Additional details (optional) (Long text)
Supporting document, if required by policy (optional) (File upload)
Confirmation (Multiple choice, required)
Frequently asked questions
What does this leave request form template collect?
Alongside contact details, it asks for phone number (optional), department, type of leave, leave start date, leave end date, full or partial days?, additional details (optional), supporting document, if required by policy (optional), confirmation. You can rename questions, change choices and remove fields that your workflow does not need.
How should I use this leave request form form?
Use this for sick, family, bereavement and other leave. Collect only the reason category you need and keep any medical documents limited to what your policy requires.
Can I edit this form and print a copy?
Yes. Open an editable draft, adjust the questions, and review the preview before publishing. You can also use the template page’s print option. Publishing requires an account; the draft can be tried first.