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Extended Leave of Absence Request Form

It is strongly recommended that the form below is completed, if you expect to be absent from work for more than 3 consecutive days at this time or some time in the near future for a personal or family medical circumstance, or any reason other than a previously approved period for personal errand, leisure, or travel.

All other leave request should be directed to your supervisor, as per your department’s attendance policy; these types of absences would include routine medical appointments, temporary absence due to non-chronic illness

UF Leave Request

Submitter Information
Employee Information

If you do not see the reason for your leave represented here, please contact your Department, Division, or College’s Human Resource Liaison for additional information regarding your leave options.  If you would like to contact the HR Benefits office directly, please go here - https://benefits.hr.ufl.edu/contact/

Based on the answers you provided, please contact your supervisor or HR Liaison for more information about this benefit.

Within 5 business days of submission , you will receive a communication from the UFHR Central Leave team with a breakdown of what leave benefits offering through UF regulations and government policy will be available for use, pending the receipt of additional information which may or may not require verifiable documentation from a third-party.