You should elaborate a little on your health condition and the treatment you wish to receive.
If possible, attach medical records or transcripts with the letter as proof.
Clearly mention the dates or the rough time period you will be gone.
If you give no concrete dates, remember to update your HR every week.
Sample of a Health Problem Leave Letter #1
Mr. Jimmy Clark
Editor in Chief
London Times Magazine
123 News Ave, London
Date: March 31, 2011
Dear Mr. Clark,
As per our discussion earlier today, I would like to take a leave for 2 weeks because of ongoing health problems. My ankle sprain has worsened, which is why I will need to take time off from work to undergo physical therapy from April 1 to April 15.
The physician who is treating me has recommended that I keep weight off my ankle, and if I don't recover within 2 weeks, I might even need surgery.
I can cover my project deadlines from home because I will be able to use my laptop in bed. Moreover, I have conducted all necessary interviews and need to complete the stories for submission and editing.
If all goes well, I Should be back to work on the 16th.
Hoping for a positive response from your end,
Health Problem Leave Letter Sample #2
Head of IT
123 Manufacturing Town, Chicago
Date: March 20, 2011
I would like to ask for a 1 week leave, from March 31 to April 7, in order to receive treatment for my carpel tunnel syndrome.
My doctor has recommended that I refrain from using a computer for at least seven days and receive physical therapy at the hospital. This will give me time to recover and relieve the pain in my wrists.
Since I will not be using any computers, I recommend Samantha Gibbons for the completion of my pending tasks. I have already discussed this with her and she is willing to cover for me while I am gone.
I hope you will consider my request favorably and grant me the requested leave.
Template of a Health Problem Leave Letter
(Name of Manager of Supervisor)
(Position in Company)
(Name of Company)
(Address of Company)
Mr. (Last name of Supervisor/Manager),
I would like to ask for a (Number of days) leave from (Start date) to (End date) in order to (Receive treatment/undergo surgery etc) for my (Health condition).
(Further details like medical history, doctor's advice, urgency of the treatment).
(Work status update and whether you can work from home or not).
I would appreciate it very much if you approved my leave.