Enclosed is information relating to your request for a leave of absence for your own health condition. (Employer Name) is not covered by the Federal Family and Medical Leave Act (FMLA), and as such, your absence falls under (Employer Name) leave of absence policies.
The following forms are enclosed in this packet:
- Application for Leave of Absence*
- Return to Work Fitness for Duty**
* To be returned to the Benefits Administrator within 15 calendar days of the date of this letter.
** To be returned to supervisor and Benefits Administrator at the expiration of the leave but prior to beginning work.
