Notice of Family Responsibility Leave - Template Form

✓ Valid in Canada (English)

Create your Notice of Family Responsibility Leave - Template Form for use in Canada (English). Answer a few plain-English questions and the document fills in automatically as you go — then download it in Word and PDF, ready to sign or share.

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Notice of Family Responsibility Leave - Template Form

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Re: Notice of Family Responsibility Leave

Dear ________,

Please accept this letter as my formal written Notice of Family Responsibility Leave. I must tend to the urgent needs of my Spouse.

I intend for my personal leave of absence to begin on ________.

This request shall also be forwarded to the appropriate department to be documented and placed in my employee file.

I must take a leave due to the medical condition of my Spouse. Upon request, I may provide reasonable evidence as proof of entitlement of my leave of absence.

If any other information regarding my personal leave of absence is required, please do not hesitate to leave me a voicemail or email, and I will attempt to make contact as soon as practicable. Should I not be in contact during my leave, I plan on returning on ________, and may be able to discuss matters with you upon my return.

Sincerely,

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