Medical Leave Letter Template

By | September 29, 2010

June 16, 2010

Peter Silvers


Silver and Gold Mining Company

23rd Black Bear Avenue, Anchorage


Dear Sir:

I am applying for a medical leave for two weeks starting the 19th of June 19 to 3rd of July.  I have been experiencing insomnia and difficulty in breathing for almost a month now. I disregarded it at first thinking that it might be perhaps normal.  But when I went to see Dr. Tyler for my check up, my condition is far from being normal.  She cited different conditions that it might be stress or changes in my metabolism as I am growing older.

According to Dr. Tyler, I needed to undergo further medical examination as to really determine the cause of my insomnia and difficulty in breathing.  Thus, it is necessary for me to take a medical leave.

My health condition is becoming a concern and I want to take precautions as much as possible.  Attached are the initial results of my medical examinations and other relevant documents.  I also furnished the human resources department a copy of my medical records and my contact details.

I shall resume my responsibilities as soon as my doctor allows me. I humbly await your approval.

Have a nice day and more power!

Sincerely Yours,

Ben Kingston

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