Fmla 2025

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The FMLA Tracker Form is designed for employers to track the Family and Medical Leave Act (FMLA) leave usage of employees with a set work schedule. It outlines how to calculate the total leave entitlement, record leave requests, and monitor hours used and remaining within a twelve-month period starting from the date of the leave request. The form emphasizes maintaining accurate records for each eligible employee and highlights that it should be used only for those with consistent schedules.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the employee's name and SSN at the top of the form.
On line 1, specify the regular schedule by noting the number of days worked per week and hours worked per day.
Calculate the total weekly hours by multiplying the values from line 1 and enter this on line 2.
Multiply the total hours from line 2 by 12 to determine the total leave allotment for the year, and write this on line 3.
Record the start date of the twelve-month period on line 4, along with any relevant end date.
As leave requests are made, document each request's date, reason, and hours used in the provided grid.
To track remaining leave, subtract used hours from your total on line 3 after each request.

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What are the laws around FMLA?

FMLA allows up to 12 weeks of unpaid leave in a 12-month period for qualifying life events. Your employer must protect your job and access to your group health benefits while you are on leave.

What is the longest you can be on FMLA?

The Family and Medical Leave Act (FMLA) provides eligible employees up to 12 workweeks of unpaid leave a year, and requires group health benefits to be maintained during the leave as if employees continued to work instead of taking leave.

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