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FairWorkMate

Family & Domestic Violence Leave Request Letter

Free template letter to request paid family and domestic violence leave. Cites the Fair Work Act (s.106A). Your request is confidential by law. Not legal advice. PDF download.

Last verified: 2 August 2026

You are not alone, and support is confidential

If you are experiencing family or domestic violence, 1800RESPECT offers free, confidential support 24 hours a day, 7 days a week — call 1800 737 732. For questions about your leave entitlement, the Fair Work Ombudsman gives free, confidential advice on 13 13 94 (fairwork.gov.au). If you are in immediate danger, call 000.

You do not need to explain why

This leave is your right. You do not have to disclose any details of your situation to use it. This tool never asks for a reason, and the letter it produces does not state one. Your employer is required by law to take reasonable steps to keep your information confidential.

Your details

Employer / manager

Your leave

Optional

General information and estimates only — not legal, financial or tax advice. Always check your specific award, agreement or contract, or a qualified professional, before you rely on the result.