A simple way for staff to put a flexible working request in writing, with room for the impact, the solutions and a clear decision recorded at the end.

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This form template is supplied in fully editable MS Word format and can be easily customised and edited. The document uses pre-defined style formatting throughout, with all text in Calibri font for improved readability.
The following document labelling is included in the footer:

• Form number and title
• Information-classification
• Version
• Page number / total pages

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Further Reading

Further guidance on flexible working and working time:

• Contracts, Policies and Working Time
• Managing Home and Hybrid Workers
• Managing Staff and Workers knowledge base

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How to Download

This file is included in the alphaZ subscription. This form is also included in the ISO 9001 Toolkit, and in every alphaZ ISO toolkit that covers managing people, so the toolkit route gives you this file plus everything else you need in one download.

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Flexible Working Request Form Template

This flexible working request form lets an employee set out a request to change how, when or where they work. It records the request, the date it should start and the reason, the likely impact and proposed solutions, any remote work location and equipment needed, and any previous request in the last 12 months.

In a management system it gives a documented record (clause 7.5) of each request and the decision made. Where the request includes remote or hybrid working, the location and equipment details support the remote working control in ISO 27001 (Annex A 6.7).

Built for Fair, Documented Decisions on Flexible Working

The form gives the employee and the business the same information to work from.

• Lists the common types of flexible working, from changed start and finish times to job sharing and term-time working.
• Asks the employee to think through the impact on their role and the company, and how it could be managed.
• Captures the remote work location, equipment and connectivity needed for home or hybrid working.
• Records the assessment, the decision and whether a home working checklist is needed.

What's Included in this Flexible Working Request Form

The employee completes the request and the business completes the office section.

• Employee details - name, date, job title and line manager.
• Overview of request - the flexible working requested, the start date wanted and the reason, with prompts for changed start or finish times, compressed hours, part-time hours, remote or hybrid working, job sharing and term-time or seasonal working.
• Impact and solutions - an optional summary of any impact on the role or the company, and proposed solutions to reduce it.
• Remote work location - where remote work will be done and any extra equipment or connectivity needed.
• Previous requests - details of any flexible working request made in the last 12 months.
• For Office Purposes Only - who assessed the request and when, whether it is approved, whether a home working checklist is to be completed, and comments.

Using the Flexible Working Request

The employee describes the change they would like, when they would like it to start and the reason for the request. The optional sections let them think through the impact on their role and how it could be managed, and anyone asking to work remotely describes where they would work and the equipment or connectivity they would need.

Recording the Decision

The For Office Purposes Only section records who assessed the request and when, whether it is approved, any comments, and whether a home working checklist is needed before remote working starts.

Who Needs a Flexible Working Request Form?

Any employer that wants requests for flexible working made and answered in a consistent way. Staff use it to make the request, and the line manager or director who decides it records the assessment and outcome in the office section.

Pairs with the Home Working Checklist

Where an approved request includes remote or hybrid working, the F-Q72 Home Working Checklist checks the home work location and equipment.