TIME-OFF REQUEST

Employee:
Team:
Submitted on:
Leave type:
First day away:
Last day away:
Expected return date:
Partial days or working hours affected (if applicable):

COVERAGE AND HANDOFF
Work that needs attention:
Agreed covering owner(s):
Handoff document link:
Work that can wait until I return:

MANAGER DECISION — complete after review
Status: Pending / Approved / Declined / Discuss dates
Reviewed by:
Decision date:
Confirmed dates:
Coverage actions to resolve:

Submitting a request does not mean it has been approved. Confirm the decision
and update the team's shared schedule.

This template is for planned time off. Follow your organization's separate
process for unexpected absences or leave requiring confidential documentation.
Keep medical details out of a shared coverage document.

Free template from Ample — https://www.ampletime.ai/time-off-request-form/