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Plan coverage

Time Off Request Form

Collect vacation, personal day, sick time, unpaid leave, and schedule-change requests with approval status and coverage notes.

Version
1.0.0
Updated
2026-08-26
Exports
PDF, Word, print
Required
5 fields
Use this when

A worker needs time away and the business needs a clear approval record for scheduling.

Then

Approve, decline, or request changes, then update the schedule and payroll or timekeeping system.

Review before sharing

Check names, dates, totals, and scope. Use a secure system for sensitive details that do not belong in a simple form.

Form progress
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Avoid unnecessary medical details. Use your formal HR process for protected leave requests.

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Live document preview1.0.0
Your business

Time Off Request Form

1.0.0

Your completed fields will appear here. Load the example to see a finished document.

FreeBusinessForms.comtime-off-request-form · v1.0.0
Agent-readable document text
TIME OFF REQUEST FORM
Document version 1.0.0


Created with FreeBusinessForms.com

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Template notes

Practical review notes

This template helps create a consistent business record from the information you provide. Review it for accuracy, keep the supporting approval or receipt with the finished file, and use qualified advice when legal, tax, payroll, regulated, or location-specific requirements matter.

Good practice

  • Use a consistent document number.
  • Keep the source approval or receipt with the form.
  • Review names, dates, totals, and scope before sending.

Machine access

Agents can inspect and validate the same versioned fields used here.

View JSON Schema →

Inspect JSON Schema
{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://freebusinessforms.com/schemas/time-off-request-form.json",
  "title": "Time Off Request Form",
  "description": "Collect vacation, personal day, sick time, unpaid leave, and schedule-change requests with approval status and coverage notes.",
  "type": "object",
  "additionalProperties": false,
  "properties": {
    "business_name": {
      "title": "Business name",
      "type": "string"
    },
    "worker_name": {
      "title": "Worker name",
      "type": "string"
    },
    "worker_email": {
      "title": "Worker email",
      "type": "string",
      "format": "email"
    },
    "request_date": {
      "title": "Request date",
      "type": "string",
      "format": "date"
    },
    "time_off_type": {
      "title": "Time off type",
      "type": "string",
      "enum": [
        "Vacation",
        "Personal",
        "Sick",
        "Unpaid",
        "Schedule change",
        "Other"
      ]
    },
    "start_date": {
      "title": "Start date",
      "type": "string",
      "format": "date"
    },
    "end_date": {
      "title": "End date",
      "type": "string",
      "format": "date"
    },
    "return_date": {
      "title": "Return date",
      "type": "string",
      "format": "date"
    },
    "coverage_plan": {
      "title": "Coverage plan",
      "type": "string"
    },
    "approval_status": {
      "title": "Approval status",
      "type": "string",
      "enum": [
        "Pending",
        "Approved",
        "Declined",
        "Needs changes"
      ]
    },
    "approver": {
      "title": "Approver",
      "type": "string"
    },
    "notes": {
      "title": "Notes",
      "type": "string",
      "description": "Avoid unnecessary medical details. Use your formal HR process for protected leave requests."
    }
  },
  "required": [
    "business_name",
    "worker_name",
    "request_date",
    "start_date",
    "end_date"
  ],
  "x-form-version": "1.0.0"
}