Flexible Working Request Form
Free Word download for UK employers, written and reviewed by our HR team.
What this form covers
- The employee's details, current working pattern and the change they are asking for
- The date they would like the change to start, and whether it is permanent or temporary
- The employee's own assessment of the effect on the business and how it could be managed
- A declaration of whether they have made a previous statutory request in the last 12 months
- A separate employer section for the consultation meeting, the decision and the statutory ground relied on if the request is refused
- An appeal section, so the whole request sits on one auditable record
When to use this form
Provide to any employee requesting flexible working. They can make two statutory requests per rolling 12 months.
The statutory process this form sits inside
- 1
Check the request is statutory
Since 6 April 2024 the right to request flexible working is a day-one right — there is no qualifying service period. An employee may make two statutory requests in any rolling 12-month period, and only one may be live at a time. A request must be in writing, dated, state that it is a statutory flexible working request, and say whether the employee has made a previous request and when.
- 2
Consult before you decide
You must not refuse a request without first consulting the employee. A short meeting is enough, but it has to be a genuine discussion of the request and of any alternative that might work — a different pattern, a trial period, or a later start date.
- 3
Decide within two months
The whole process, including any appeal you choose to offer, must be completed within two months of the date the request was received, unless you and the employee agree in writing to extend it. There is no separate statutory deadline to acknowledge the request, but writing back quickly is good practice and starts the clock clearly.
- 4
Refuse only on a statutory ground
A request can only be refused for one or more of the eight statutory business reasons: the burden of additional costs; a detrimental effect on ability to meet customer demand; inability to reorganise work among existing staff; inability to recruit additional staff; a detrimental impact on quality; a detrimental impact on performance; insufficiency of work during the periods the employee proposes to work; or planned structural changes. Name the ground and explain the business facts behind it in writing.
- 5
Confirm the outcome and vary the contract
If you agree the change, it is a permanent variation to the contract unless you have both agreed a trial or a temporary arrangement in writing. Issue a written variation and update payroll, holiday entitlement and any pro-rata benefits.
How to complete it
Acknowledge receipt within a few days. You must respond within two months including any appeal.
Common mistakes we see
- Refusing because of a general preference for staff being on site, rather than one of the eight statutory grounds
- Deciding without any meeting, which now breaches the duty to consult
- Missing the two-month deadline and only noticing when the employee chases
- Treating an agreed change as informal, so the contract is never varied and pay, holiday and pension are calculated on the old pattern
- Ignoring the discrimination angle — a refusal that disadvantages a carer, a disabled employee or a mother returning from maternity leave can found a separate claim even where the flexible working process was followed
This template is provided for general use and does not constitute legal advice. If your situation is complex, contact one of our HR experts before sending or signing.
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