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Click ‘Get Form’ to open the FMLA Tracker Form in the editor.
Begin by entering the employee's name and Social Security Number (SSN) in the designated fields at the top of the form.
Fill in the 'Leave Request Dated' field with the date you are submitting this request.
Specify the reason for leave in the corresponding section, ensuring it aligns with FMLA guidelines.
Indicate the beginning date of leave in the next field, which marks when your leave will commence.
Enter the employee's average number of hours worked per week over the past twelve weeks to calculate total leave allotment.
Calculate and input total leave allotment for a twelve-month period by multiplying line 2 by 12.
Document total leave used in the previous twelve months on line 4, converting days or weeks into hours as necessary.
Determine remaining available leave by subtracting total leave used from total leave allotment on line 5.
Specify how many hours of leave you wish to use for this request on line 6.
Finally, calculate and enter remaining leave after this request on line 7 by subtracting requested hours from available leave.

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What are the rules around 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.

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.