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FFCRA Leave Request Form

Formally Document FFCRA Time Off Requests


The Families First Coronavirus Response Act (FFCRA) was put in place to protect workers affected by COVID-19 by allowing them to take paid (or partially paid) time off for certain absences related to the pandemic.


Use the attorney-developed FFCRA Leave Request Form to formally document the employee’s reason(s) for requesting time off as well as your response.

This form satisfies mandatory DOL and IRS recordkeeping requirements by capturing the specific information employers must document to qualify for tax relief under the Act. See more details...

SKU: A0105
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$28.99
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  • Attorney-developed and compliant with the latest regulations
  • Includes a Tip Sheet covering compliance guidelines and recommended best practices from our expert HR and legal teams
  • Size: 8.5" x 11", 2-sided
  • Available in packs of 25 or 50
  • Attorney-developed and compliant with the latest regulations
  • Includes a Tip Sheet covering compliance guidelines and recommended best practices from our expert HR and legal teams
  • Size: 8.5" x 11", 2-sided
  • Available in packs of 25 or 50
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