Personal Leave Request Form

Please use this form to request an unpaid leave of absence for personal purposes. Please note, requests are subject to leader approval and must be submitted a minimum of four (4) weeks in advance of the requested start date. Once the form is submitted, you will receive a response with a decision within 7-10 days.

If your personal leave request is medical related (ie., sick, compassionate care), please do not complete this form. Please reach out to OrganizationalHealth@bchsys.org for the appropriate resources and support.