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1. Employee Information: Full name, employee ID, department, and position of the employee requesting leave
2. Date and Address: Current date and proper business letter formatting with recipient's details
3. Subject Line: Clear indication that this is a leave request for eye checkup
4. Leave Duration: Specific date(s) and time required for the eye checkup, including travel time if necessary
5. Purpose Statement: Brief explanation of the need for eye checkup
6. Work Coverage Plan: Brief mention of how ongoing work will be handled during absence
7. Contact Information: Emergency contact details during leave period
8. Signature Block: Employee signature, date, and space for supervisor approval
1. Previous Leave History: Include when required by company policy or if there have been recent medical leaves
2. Medical History Reference: Include if the checkup is related to an ongoing eye condition or previous diagnosis
3. Return to Work Statement: Include if the checkup might require extended recovery time
4. Transportation Requirements: Include if employee needs special transportation arrangements due to eye dilation
1. Medical Appointment Confirmation: Attachment showing confirmed appointment with the eye care provider
2. Medical Certificate: To be attached after the checkup confirming attendance and any follow-up requirements
3. Insurance Coverage Document: If required by employer, proof of insurance coverage for the medical visit
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