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Remote work request form template

Propose a work-from-home or hybrid arrangement.

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How to make a remote work request form

  1. 1

    Check the questions: rename, add or delete any field, or change how it’s answered.

  2. 2

    Add your organisation’s name, a contact line and your logo if you like.

  3. 3

    Choose fillable PDF, printable PDF, Word or HTML, and the paper size.

  4. 4

    Download the remote work request form and share it, print it or add it to your website.

About this remote work request form

A remote work request sets out a proposed work-from-home or hybrid arrangement and how it will work in practice: which days, working hours, how the person will stay reachable, their home setup and any equipment needed. Managers can approve it, approve it with changes or agree a trial period.

It suits both a one-off period (a house move, recovery from surgery) and an ongoing hybrid pattern.

What’s on the remote work request form

The template has 5 sections and 18 questions. Every one can be renamed, moved or deleted.

  • Employee: Name; Job title; Department; Manager
  • Proposed arrangement: Type (choose one: Fully remote, Hybrid, Temporary remote); Remote days (tick all that apply: Monday, Tuesday, Wednesday, Thursday, Friday, Saturday); Start date; End date (if temporary); Working hours; Reason for request
  • How it will work: How will you stay in touch with the team?; Home workspace and internet; Equipment needed (tick all that apply: Laptop, Monitor, Headset, Phone, Internet allowance, None)
  • Employee signature: Employee signature with date
  • Approval: Decision (choose one: Approved, Trial approved, Not approved); Review date; Comments; Manager signature with date

Tips

  • Propose a review date, especially for a new arrangement.
  • Confirm the home connection and a quiet workspace up front.
  • Check data security rules for working with confidential information at home.

Four ways to save it

A fillable PDF has typing boxes, tick boxes and choices built in. A printable PDF gives clean boxes and writing lines for pen and paper. The Word file can be edited further, and the HTML code adds the same questions to a website. Browse more form templates, or design a completely different layout in the custom form builder.

Frequently asked questions

Do employees have a right to work remotely?

It depends on the country and your contract. Some places give a right to request flexible work, which the employer must consider fairly.

Should remote work have a trial period?

A one- to three-month trial with a review date is a common way to test an arrangement. There’s a field for it in the approval section.

Is anything I type sent to a server?

No. The editor runs in your browser and builds the file on your device. Atifo has no server that could receive your form or the answers on it.

Can I put the remote work request form on my website?

Yes. Choose “HTML” to copy ready-made form code with labels and a simple style. Set the form’s action to the address that should receive submissions, such as your own form handler.

Can people fill in this remote work request form on a phone?

Yes. Choose “Fillable PDF” and send the file. It opens in the Files or Drive app on Android, Files on iPhone, and any browser on a computer, where people can type their answers and save the result.

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