Leave of Absence Request Form

Please note that Spring ISD is committed to providing a safe and healthy learning space for students, staff, and the community. All leave requests will require a valid email address (work or personal) to receive the proper FMLA documentation. A completed request should be submitted to the Human Resources Benefits Office at least 30 days prior to the date the requested leave is to begin. Documentation for absences over five (5) days for self or for a family member is required. When seeking leave you must provide medical certification within 15 calendar days. Leave under the Family Medical Leave Act (FMLA) requires you have worked at least one year AND at least 1250 hours in the last 12 months to qualify for up to 12 weeks unpaid leave under certain circumstances. YOU MUST HAVE STATE AND LOCAL DAYS TO CONTINUE TO RECEIVE A PAYCHECK. Should you receive no paycheck, you will be responsible for the direct payment of benefit premiums. Family and Medical leave shall run concurrently with applicable paid leave and compensatory time, as applicable

Select or enter value
Caret IconCaret symbol

Please enter the email address you would prefer to use to communicate about your leave status.

Phone

Please indicate the timeframe you intend to take leave (ex. 9/1/2023-11/1/2023)

Select
Caret IconCaret symbol
Select
Caret IconCaret symbol
Select
Caret IconCaret symbol
Powered by Smartsheet Modern Logo On Light
Privacy Notice|Report Abuse