Flexible Working Request Templates

Use these templates to manage flexible working requests professionally.

Employee Request Form

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Flexible Working Request Form

Section 1: Employee Details

Field	Information
Name
Job Title
Department
Manager
Start Date
Date of Request

Section 2: Current Working Pattern

Current Arrangement	Details
Days worked
Hours per week
Start/finish times
Work location

Section 3: Requested Change

Proposed Arrangement	Details
Days to work
Hours per week
Start/finish times
Work location
Proposed start date

Section 4: Type of Change Requested

Please tick all that apply:

• Reduced hours
• Compressed hours (same hours, fewer days)
• Different start/finish times
• Working from home (full time)
• Hybrid working (part home, part office)
• Job share
• Term-time only
• Other (please specify): ________________

Section 5: Impact and Solutions

Please explain how you think the change might affect the business and how any impact could be managed:

[Space for employee to write]

Section 6: Declaration

• I confirm this is a statutory flexible working request
• I understand the employer must respond within 2 months
• I understand I can make 2 requests per 12-month period

Signature: _________________ Date: _________________

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Acknowledgement Letter

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[Company Name] [Company Address]

[Date]

[Employee Name]

Dear [Employee Name],

Flexible Working Request - Acknowledgement

Thank you for your flexible working request dated [date].

I acknowledge receipt of your request to [brief description of change requested, e.g., reduce your hours from 40 to 30 per week / work from home 3 days per week].

Next Steps

In accordance with the statutory procedure, I will arrange a meeting with you to discuss your request. You will receive an invitation within the next [X] days.

At the meeting, we will discuss:

• The details of your request
• How it might work in practice
• Any impact on the team or business
• Possible alternatives if your exact request isn't feasible

Your Rights

You have the right to be accompanied at this meeting by a work colleague or trade union representative. Please let me know if you wish to bring a companion.

Timeframe

We will complete the process, including any appeal, within 2 months of receiving your request (by [date]).

If you have any questions, please contact me.

Yours sincerely,

[Name] [Job Title]

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Approval Letter

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[Company Name] [Company Address]

[Date]

[Employee Name]

Dear [Employee Name],

Flexible Working Request - Approved

Following our meeting on [date] to discuss your flexible working request, I am pleased to confirm that your request has been approved.

Approved Changes

Element	New Arrangement
Working days	[Days]
Working hours	[X] hours per week
Start/finish times	[Times]
Work location	[Location/hybrid arrangement]
Effective from	[Date]

Contract Variation

This change constitutes a permanent variation to your contract of employment, unless otherwise agreed. [If trial period agreed:] We have agreed a trial period of [X] months, after which we will review the arrangement.

Salary Adjustment

[If hours reduced:] Your salary will be adjusted pro-rata to reflect your new working hours. Your new salary will be £[amount] per annum (£[amount] gross per month).

[If no change:] Your salary remains unchanged.

Holiday Entitlement

[If hours changed:] Your holiday entitlement will be adjusted pro-rata. Your new annual entitlement is [X] days (plus bank holidays pro-rata).

Other Terms

All other terms and conditions of your employment remain unchanged.

Review

We will review this arrangement after [3/6] months to ensure it continues to work for both you and the business.

Please sign and return the enclosed copy of this letter to confirm your agreement to these changes.

Yours sincerely,

[Name] [Job Title]

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Acknowledgement

I confirm my agreement to the above changes to my working arrangements.

Signature: _________________ Date: _________________

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Refusal Letter

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[Company Name] [Company Address]

[Date]

[Employee Name]

Dear [Employee Name],

Flexible Working Request - Decision

Following our meeting on [date] to discuss your flexible working request, I have carefully considered your proposal to [brief description of request].

Decision

I regret to inform you that I am unable to approve your request.

Reason for Refusal

Your request is refused on the following statutory ground(s):

[Select applicable reason(s):]

• The burden of additional costs
• Detrimental effect on ability to meet customer demand
• Inability to reorganise work among existing staff
• Inability to recruit additional staff
• Detrimental impact on quality
• Detrimental impact on performance
• Insufficiency of work during the periods you propose to work
• Planned structural changes

Explanation

[Provide a full explanation of why the request cannot be accommodated, e.g.:]

Your request to work from home full-time cannot be accommodated because [specific business reason - e.g., "your role requires daily face-to-face interaction with customers in the office" / "we have been unable to identify a way to ensure adequate coverage of the reception desk during your proposed absence days"].

We considered the following alternatives:

• [Alternative 1 considered and why not workable]
• [Alternative 2 considered and why not workable]

Right of Appeal

You have the right to appeal against this decision. If you wish to appeal, please write to [Name, Job Title] within [14] days of receiving this letter, setting out the grounds for your appeal.

If you would like to discuss alternative arrangements that might be feasible, I would be happy to meet with you.

Yours sincerely,

[Name] [Job Title]

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Key Points

Statutory Grounds for Refusal

Ground	Example
Burden of additional costs	Would need to hire cover
Customer demand	Cannot meet service levels
Cannot reorganise	No one to do the work
Cannot recruit	Cannot find suitable staff
Quality impact	Work would suffer
Performance impact	Output would reduce
Insufficient work	Not enough to do in proposed hours
Structural changes	Reorganisation planned

Timeline

Stage	Timeframe
Acknowledge receipt	Promptly (within days)
Hold meeting	Without unreasonable delay
Notify decision	As soon as reasonably practicable
Complete process (incl. appeal)	Within 2 months of request