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Request for Family Medical Leave - Template Form

✓ Designed for use in Nigeria

Create your Request for Family Medical Leave for use in Nigeria. 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.

  • Answer 19 simple questions - the document fills in as you go
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  • Edit your answers and re-download anytime

How it works

  1. 1Answer a few simple questions
  2. 2Preview your document live
  3. 3Pay once - download in Word & PDF

Below you can preview the Request for Family Medical Leave, complete it by answering a few plain-English questions, and download a ready-to-sign copy in Word and PDF - tailored for use in Nigeria.

What the Request for Family Medical Leave includes

This template is organised into the following sections:

Frequently asked questions

What is a Request for Family Medical Leave?

A Request for Family Medical Leave is a ready-to-use legal template for Nigeria. You complete it by answering a few plain-English questions, then download the finished document in Word and PDF.

What does the Request for Family Medical Leave cover?

The Request for Family Medical Leave is organised into sections covering § 1. Particulars of the Application, § 2. Duration of Leave, § 3. Supporting Documentation, § 4. Continuity of Work and Handover, § 5. Contact During Leave, so the important points are captured in a clear, consistent structure.

What formats can I download?

You can download your completed Request for Family Medical Leave as an editable Microsoft Word (.docx) file and as a PDF.

Can I edit the document later?

Yes - save it to your account and you can re-open, edit and re-download it at any time.

Is a Request for Family Medical Leave legally binding?

Once it is properly completed and signed by everyone involved, a Request for Family Medical Leave is generally legally binding in Nigeria, provided it meets the legal requirements that apply to this type of document.

What laws apply to a Request for Family Medical Leave in Nigeria?

A Request for Family Medical Leave should comply with the laws in force in Nigeria. This template is built around the provisions such situations commonly require, but the rules can vary by region and change over time, so check the current requirements for your case.

Do I need a lawyer to use a Request for Family Medical Leave?

For most standard situations you can complete the Request for Family Medical Leave yourself using the guided questionnaire. For high-value, unusual or high-risk matters, it is sensible to have a qualified lawyer review the finished document.

How do I sign the Request for Family Medical Leave?

Download the completed Request for Family Medical Leave as Word or PDF and sign it as required in Nigeria. Depending on the document this may involve a handwritten or electronic signature, and some documents also need witnesses.

Is the Request for Family Medical Leave free?

You can preview the Request for Family Medical Leave and fill it in for free. A one-time fee applies only when you download the finished, ready-to-sign document in Word and PDF.

How long does it take to complete a Request for Family Medical Leave?

Most people finish the Request for Family Medical Leave in just a few minutes by answering the plain-English questions. You can save your progress and come back to it at any time.

Prepared and reviewed by the LegalDocs team.

Document preview

________
________
Employee Identification/Staff Number: ________
Designation/Department: ________

________

________
(The Human Resources Manager / Head of Department)
________

Dear Sir/Madam,

RE: FORMAL APPLICATION FOR FAMILY/COMPASSIONATE LEAVE

I write further to the conversation we held on ________ concerning my request for leave from my employment with ________ ("the Company"), and pursuant to the terms of my contract of employment dated ________, the Company's Staff Handbook/Leave Policy, and the applicable provisions of the Labour Act, Cap. L1, Laws of the Federation of Nigeria 2004.

§ 1. Particulars of the Application
I respectfully apply for family/compassionate leave for a period of ________ in order to care for my spouse/relative, who is presently unwell. The relationship of the said person to me is that of ________.

§ 2. Duration of Leave
The leave is expected to commence on ________ and to conclude on ________, after which I undertake to resume my duties without delay.

§ 3. Supporting Documentation
In support of this application, and in accordance with the Company's policy, I enclose herewith a medical certificate dated ________ issued by ________ evidencing the need for the leave applied for. I confirm that the personal and medical information contained therein is provided solely for the purpose of processing this application, and I request that it be handled in accordance with the Nigeria Data Protection Act 2023.

§ 4. Continuity of Work and Handover
To ensure minimal disruption to the operations of the Company during my absence, I have made or am willing to make arrangements for the handover of my responsibilities to ________ or to such other officer as the Company may direct.

§ 5. Contact During Leave
Should any urgent matter arise during the period of my leave, I may be reached by telephone on ________ or by electronic mail at ________.


Yours faithfully,




__________________
________
Signature & Date: ________

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Fields you complete are inserted into the document live. This template is general guidance only - not legal advice.