This leave of absence example letter provides a written request for a leave of absence from work for medical reasons.
Review additional absence excuse letter samples.
Letter Example Requesting a Leave of Absence for Medical Reasons
Your Name
Your Address
Your City, State, Zip Code
Your Phone Number
Date
Name
Title
Organization
Address
City, State, Zip Code
Dear Mr./Ms. Last Name:
I would like to request a leave of absence for medical reasons. I will be having hernia surgery on September 1 and expect to return to work approximately three weeks later.
I can provide written documentation from the surgeon, if necessary.
Thank you very much for your consideration.
Sincerely,
Your Signature
Your Typed Name
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Please Note: This sample is provided for guidance only. The provided information, including samples and examples, is not guaranteed for accuracy or legality. Letters and other correspondence should be edited to fit your personal situation.

