USA Work Leave Request Form
The Family and Medical Leave Act (FMLA) entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. For more information about leave eligibility under the FMLA, please see here.
It is important to know that leaves of absence are not to be used to request sick days. If you are calling in absent for your shift, you are required call-in through the call-in procedure specific to your assignment.
Please submit your Work Leave Request Form at least 30 days prior to a planned leave. If the leave is not foreseeable, associates are to provide notice as soon as possible. The Job Shoppe will not accept any other request methods, including phone calls, separate emails or verbal communications.
When the need for leave is foreseeable based on an expected birth, placement for adoption or foster care, or planned medical treatment, an employee must give at least 30 days notice. If 30 days notice is not possible, an employee is required to provide notice “as soon as practicable.
Once The Job Shoppe receives your request, a representative will review that request and will follow up with you to advise if your request has been approved or denied, and if any additional information or documentation is required.