🏥 Medical Leave & Work Accommodation Request

A template to help you ask for time off, remote work, flexible hours, or other support from your employer — clearly, respectfully, and without having to find all the right words yourself.

🔍 What this tool is

This tool helps you write a message to your employer or HR department when you need time off, medical leave, schedule changes, or workplace accommodations — either for yourself or to support a loved one.

Whether you’re recovering from something, managing a chronic condition, preparing for a medical procedure, or supporting someone else, this tool gives you a calm place to begin.

• 🔒 Private by design
  Everything you type stays on your device. We don’t collect or store anything.
• 📎 Not legal advice
  This is a writing tool — not a substitute for legal, medical, or HR counsel.

🛠️ Ready to start? Jump to the form

📝 Example output

Hi HR Team,

I’m writing to request medical leave and a temporary workplace accommodation.

I’m recovering from surgery and will need two weeks off, followed by a transition period where I work from home.

The requested timeframe is August 12–26.

Requested support: Two weeks of leave, followed by remote work for 1–2 additional weeks if possible.

Thank you for your time and understanding.

Jordan Reyes

📋 Generated Request

You can copy, print, or share this message — whatever works best.

📌 Want to get the most out of this tool? Visit How to Use KindScript.