Excel (.xlsx) · printable · includes request log · No signup required
Part 1 — employee request: leave type (vacation / sick / personal / unpaid), first and last day off, return date, shifts affected
Part 2 — manager decision: received date, approved/denied, decided by, coverage plan
A request log table — one row per request, the manager’s single source of truth
Printable layout that also works as a shared spreadsheet
Open the .xlsx in Excel or Google Sheets, or print a stack for the back office.
Leave type, first and last day off, the date they’re back, and how many scheduled shifts are affected.
Record when the request came in, the decision, who made it, and the coverage plan — the part that prevents the approved absence from becoming an open hole.
Add one row to the request log. When someone says “I asked for that weekend off”, the log answers whether they did and what was decided.
Before publishing any schedule, scan the log for approved absences in its date range — or use EpicShifts, where approved time off blocks scheduling automatically.
For any team where time-off requests currently arrive by text, sticky note, or conversation — which is most small hourly teams. The form’s real value is the decision record and the log, not the request itself: disputes are almost always about what was approved, not what was asked. What paper can’t do is enforce itself — an approved request only protects the employee if whoever builds the schedule remembers to check the log.
Already filled it in? Upload the file to EpicShifts and we’ll import it into a live schedule — your team sees their shifts on mobile, swaps and picks up open shifts, and gets reminders automatically.
The employee’s name, the type of leave, the first and last day off, the return-to-work date, the number of scheduled shifts affected, and a manager section recording the decision, who made it, and the coverage plan. This template includes all of those plus a running request log.
Most hourly workplaces require at least two weeks’ notice for planned time off — enough to adjust the next schedule before it’s built. Put your notice window in the posted policy and apply it consistently; ad-hoc exceptions are what make approvals feel unfair.
A signed form is documentation, not a contract — but a written approval record is what resolves most disputes, and in some jurisdictions predictive-scheduling laws penalize employers for late schedule changes. The practical rule: write approvals down, then honor them.
Dustin Hanke, Founder, EpicShifts — Dustin builds EpicShifts and writes about scheduling, labor cost, and shift-work operations for restaurants and other hourly teams.
We use cookies to improve your experience on our platform. Essential cookies are required for the site to function properly (authentication, security). Optional cookies help us understand how you use the site and improve our services. Learn more about cookies