Attorney Leave of Absence Form
Submit your request for a leave of absence. Please complete all sections accurately to ensure timely processing.
Attorney Full Name
*
First Name
Last Name
Bar Number or Attorney ID
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department or Practice Area
*
Please Select
Litigation
Corporate
Family Law
Criminal Law
Intellectual Property
Other
Type of Leave
*
Vacation
Medical
Personal
Jury Duty
Bereavement
Other
Start Date of Leave
*
-
Month
-
Day
Year
Date
End Date of Leave
*
-
Month
-
Day
Year
Date
Reason for Leave (please provide brief details)
*
Who will cover your cases/responsibilities during your absence? (Name and contact information)
*
Emergency Contact During Leave (Name, Relationship, Phone)
Supervisor or Managing Attorney Name
*
Signature of Attorney
*
Submit Leave Request
Submit Leave Request
Should be Empty: