Leave Request

Complete this form to request additional leave from work, including FMLA/ADA leave, Catastrophic leave or any qualified leave exceeding your policy sick, personal and vacation allotments. Your request will go to Talent Solutions for review, who will then reach out to you with any additional questions. If you have further questions about any part of this Form, contact our Talent Solutions Department at 1-877-678-2705 or email us at talentsolutions@marketstar.com

* Employee Name

* Employee Job Title

* Email Address

* Phone Number

* Team

* Country/State

* Manager Name

* Manager Phone Number

*Leave Type

* Catastrophic Leave Bank Type

* Explain Other Leave Type

*Date expected to return to work

* Work Status

* Notes

* Required Field