Sample Leave Application for Medical Treatment

By | December 19, 2016

Everybody gets sick once in a while and sometimes you miss important things like, school or work. Yeah, I know, some of you love getting sick just so that they can stay home, away from all the responsibilities and duties. Well, I hate to break it to you, but you still have one important duty; writing your leave application.

I understand that most people find this to be the most tedious task in the world, but this one simple application can save you from being suspended from a class, or fired from work, and it helps you maintain a good reputation as someone who doesn’t just go AWOL.

Having trouble writing your application? Here are a few pointers

Give Proof
Whenever anyone reads an application claiming that the applicant is ill and they don’t see a doctor’s note attached to it, they never believe it, and they simply think that the applicant is lying. There have been too many people who lied just to get out of work, and this has led to us having to send a physician’s report as proof of our inability to come to work. It’s always better to send a medical report attached with your application, so that no one can give you any trouble later.

Give your boss a break. By that, I mean, arrange everything so that your work is still done on time; find a colleague to cover for you, take some work home, promise to put in some overtime, and whatever else you can think of. This will make it a lot easier for your application to be accepted, and it will make you look responsible reliable.

Be Respectful
Even if you supervisor is your best friend, you always have to be polite and respectful in your official correspondence. This application will not be seen by just one person, in fact, in some systems it needs to be accepted by someone higher up. Your professional image depends a lot on what you put on paper, and how you present it.

Know Your Contract
It’s important to have a thorough understanding of the work contract you have signed, and what policies are in place for medical leave. Some companies have specific rules and formats. It’s good to be well informed and follow the rules. It saves you a lot of trouble in the long run.
Here’s a sample leave application for medical treatment:


Sample Leave Application for Medical Treatment


Alex Gordon
Bloomingdale Savings Bank ltd.
840 George Street
Gainesville, FL 32601

December 19, 2016

Mr. John Ratner
Branch Manager
Bloomingdale Savings Bank ltd.


Dear Mr. Ratner:

I am writing this application to ask for one week’s leave, starting from Wednesday, 21 December, 2016 to Tuesday, 26 December, 2016. The reason is I have injured my calf muscle very badly in a game of basketball.

I have multiple muscle tears, and I’ve been instructed by a doctor to stay off my leg for a week. A doctor’s report is enclosed with this application.

I’ve asked Diana from the temp agency to cover for me in my absence, pending your approval. I would be grateful if you can grant me this leave, and I will try to come sooner if I am able.

I look forward to your prompt response.




Alex Gordon