Brown University Human Resources Leave of Absence Inquiry Form

Contact Information

Name

Telephone Number

Workday ID#

Brown Email Address

Please select your primary role at the University from the selection below.

FacultyRegular StaffResearch Associate/ FellowSeasonal StaffStudent Employee

Are you completing this on your own behalf?

YesNo

Please enter the name of the person you are inquiring for.

Inquiry Topic

Please select the primary topic of your question from the list below. 

FMLA (Intermittent or Continuous)Medical Leave for SelfMedical Leave for FamilyOther Type of Leave (Maternity, Parental, Personal, Military, etc.)Worker's CompensationDisability Insurance ( State, Long-Term, etc.)Accommodations (General, Parking, Pregnancy, Transportation, etc.)Time-Off Accural

What do you need help with?

Select a question from below. If you select other, please use the space below.

Please select... I have questions about initiating a Leave of Absence request in Workday. I have questions about Maternity/ Parental Leave options and benefits. I have questions about FMLA or State Leave eligibility. I have questions about compensation while on leave. I have questions about the required documentation to support my Leave of Absence request. I have questions about the required documentation to support my Return to work. I have questions about extending my Leave of Absence beyond FMLA entitlement. Who approves and manages a Leave of Absence Request? I have questions about requesting workplace accommodations. I have questions about Benefits Billing during Unpaid Leave. I have a question about missing or incorrect paid time-off balances and/or accrual. Other

Inquiry Questions

Leave of Absence Additional Information

Use this section to include information related to your Leave inquiry or you may ask a question that is not listed above.

Anticipated Leave Dates

Start 

End

Is this inquiry related to your return from leave due to your own medical condition?

YesNo

You are welcome to join our virtual office for a confidential consultation to discuss your inquiry. To schedule your appointment, please select the 15-minute time slot that works for you. Once confirmed, a calendar invitation with the Zoom link will be sent to you. 

Tuesday at 9amTuesday at 2pmThursday at 10amThursday at 2pm