Flexible Working Request (Canada)
Formal Request for Modified Work Arrangement
FLEXIBLE WORKING REQUEST
Formal Request for Modified Work Arrangement
To: [Manager Name], [Company Name]
From: [Employee Name], [Job Title], [Department]
Date: [Request Date]
Province of Employment: [Province]
I am writing to formally request a change to my current work arrangement, pursuant to the applicable employment standards legislation for [Province] and, where applicable, the Canada Labour Code (R.S.C. 1985, c. L-2), Division XV.3 (ss.177.1–177.1(9)). I have been employed by [Company Name] since [Start Date] and request this change to take effect on [Proposed Start Date].
1. REQUESTED ARRANGEMENT
1. REQUESTED ARRANGEMENT
Type of arrangement requested: [Arrangement Type]
Current schedule:
[Current Schedule]
Proposed new schedule:
[Proposed Schedule]
Proposed effective date: [Proposed Start Date]
Duration: [Duration]
Proposed end date (if temporary): [End Date]
2. REASON FOR REQUEST
2. REASON FOR REQUEST
[Reason for Request]
3. OPERATIONAL IMPACT & PROPOSED SOLUTION
3. OPERATIONAL IMPACT & PROPOSED SOLUTION
Anticipated effect on operations:
[Operational Impact]
Proposed solution to manage impact:
[Proposed Solution]
I respectfully request that this application be considered and that a written response be provided within a reasonable time. I am available to discuss this request at a mutually convenient time. If this request engages the employer's duty to accommodate under the applicable human rights legislation for [Province], I am prepared to participate in a collaborative accommodation process.
CC: [HR Contact]
EMPLOYER RESPONSE (to be completed by management)
EMPLOYER RESPONSE (to be completed by management)
Decision: ☐ Approved ☐ Approved with modifications ☐ Deferred ☐ Refused
If approved — effective date: ______________________
If refused — operational grounds for refusal: ______________________
Response date: ______________________
Employee
________________
Signature
Manager / Employer Representative
________________
Signature
What Is a Flexible Working Request (Canada)?
A Flexible Working Request in Canada records an employee’s request to vary their working hours, location, or pattern and the employer’s response, governed primarily by provincial Employment Standards legislation.
Flexible working law in Canada is evolving rapidly. At the federal level, the Budget Implementation Act, 2018, No. 2 amended the Canada Labour Code (R.S.C. 1985, c. L-2) to add Division XV.3, which gives employees in federally regulated workplaces the right to formally request flexible work arrangements after six continuous months of employment. The employer must respond in writing within 45 days and, if refusing, must cite one of the enumerated operational grounds set out in s.177.1(5).
At the provincial level, Ontario's Working for Workers Act, 2021 (S.O. 2021, c. 34) amended the Employment Standards Act, 2000 to require employers with 25 or more employees to have a written policy on employees working from home (ESA s.21.1.2), and the Employment Standards Act, 2000 has long included provisions for employees to request schedule changes and to take family responsibility leave. BC's Employment Standards Act permits compressed workweek agreements between employer and employee (s.37), and Alberta's Employment Standards Code allows for modified work schedule agreements to alter the standard overtime calculation period (s.70).
Beyond the formal statutory frameworks, flexible working requests increasingly engage the employer's duty to accommodate under human rights legislation. Where an employee's request for flexible working is connected to a disability, family status obligation (which Canadian courts have interpreted broadly to include childcare and eldercare needs), or religious observance, the employer may have a duty to accommodate to the point of undue hardship under the applicable human rights code — a higher standard than the mere operational convenience test that governs a standard flexible working request.
A formal written flexible working request creates clarity for both parties, documents the employee's needs and proposed solution, and establishes a paper trail if the request is refused and a human rights complaint or grievance follows.
The legal framework governing the Flexible Working Request (Canada) in Canada draws on several key statutes and regulatory bodies. Under the Canada Labour Code (R.S.C. 1985, c. L-2), the Canada Industrial Relations Board adjudicates federal workplace disputes. Provincial employment standards legislation — including Ontario's Employment Standards Act 2000 and British Columbia's Employment Standards Act (RSBC 1996) — governs minimum employment terms. The Personal Information Protection and Electronic Documents Act (PIPEDA) governs private-sector data handling. The Canada Revenue Agency (CRA) administers source deductions and Canada Pension Plan (CPP) contributions. Parties executing a Flexible Working Request (Canada) in Canada should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Canada Labour Code (R.S.C. 1985, c. L-2) sets the foundational requirements.
When Do You Need a Flexible Working Request (Canada)?
A Flexible Working Request form should be used whenever an employee wishes to formally change the terms of their existing work schedule, location, or hours — whether temporarily or on a permanent basis. Examples include an employee returning from parental leave who wants to work a reduced schedule, an employee with a new childcare arrangement who needs to shift start and finish times, an employee with a disability requiring a home-office accommodation, or an employee who wants to trial a compressed workweek to reduce commuting time.
For federally regulated employees, the formal request procedure under Canada Labour Code s.177.1 requires the request to be in writing, to specify the change requested and the date on which it is to take effect, and to explain the effect the employee anticipates the change will have on the employer. This form is designed to meet those statutory requirements.
For provincially regulated employees, a written request is not always legally mandated but is strongly recommended as it: creates a clear record of what was requested and when; triggers the employer's obligation to consider and respond; documents the employee's explanation of the proposed solution to any operational impact; and forms the basis for any subsequent grievance, human rights complaint, or civil action if the request is improperly refused.
The request should be submitted at least four to eight weeks before the desired effective date — or more in larger organizations — to allow reasonable time for consideration, operational planning, and formal approval. Where the flexible working arrangement is connected to a medical need or family status obligation, the request should ideally be accompanied by supporting documentation (medical note or childcare documentation) to support the accommodation analysis and demonstrate good faith by the employee.
Parties in Canada should prepare a Flexible Working Request (Canada) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under the Canada Labour Code (R.S.C. 1985, c. L-2), the Canada Industrial Relations Board adjudicates federal workplace disputes. Provincial employment standards legislation — including Ontario's Employment Standards Act 2000 and British Columbia's Employment Standards Act (RSBC 1996) — governs minimum employment terms. The Personal Information Protection and Electronic Documents Act (PIPEDA) governs private-sector data handling. The Canada Revenue Agency (CRA) administers source deductions and Canada Pension Plan (CPP) contributions. Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.
What to Include in Your Flexible Working Request (Canada)
A thorough Canadian Flexible Working Request must begin with the employee's identifying information: full name, job title, department, employment start date, province of employment, and the name of their direct manager and HR contact.
The request details section is the core of the document. The employee must clearly specify: (1) the type of flexible arrangement requested (remote work, reduced hours, compressed workweek, flexitime start/finish, job share, or other); (2) the current schedule and hours; (3) the proposed new schedule and hours; (4) the proposed effective date; and (5) whether the change is requested on a temporary or permanent basis — with an end date if temporary.
The business impact and proposed solution section requires the employee to address how the proposed change will affect the employer's operations and clients, and to outline how the employee proposes to mitigate any negative impact. This mirrors the statutory requirement under Canada Labour Code s.177.1(3)(c) that the employee explain the anticipated effect on the employer and any proposed solution.
The reason for request section captures the employee's rationale — whether personal, family-related, disability-related, or career-motivated — without requiring disclosure of confidential medical information beyond what is necessary for accommodation analysis. Where the reason engages the employer's duty to accommodate under human rights legislation, the employee should indicate this.
The employer response section (completed by HR or the manager) should record the decision (approved, approved with modifications, deferred pending review, or refused), the effective date of any approved change, any conditions attached to approval, and — if refused — the specific operational grounds for refusal as required under applicable legislation. Both parties should sign the completed form, creating a binding agreement if approved or a formal record if refused.
Additional compliance elements for a Flexible Working Request (Canada) used in Canada include: Under the Canada Labour Code (R.S.C. 1985, c. L-2), the Canada Industrial Relations Board adjudicates federal workplace disputes. Provincial employment standards legislation — including Ontario's Employment Standards Act 2000 and British Columbia's Employment Standards Act (RSBC 1996) — governs minimum employment terms. The Personal Information Protection and Electronic Documents Act (PIPEDA) governs private-sector data handling. The Canada Revenue Agency (CRA) administers source deductions and Canada Pension Plan (CPP) contributions. Forms-legal.com provides this template as a starting point for Canada-compliant documentation.
Sources & Citations
Statutory citations link to official government sources.
- R.S.C. 1985, c. L-2CA official
Cite this page
Reference this free template in an article, syllabus, or research note:
Forms Legal. (2026). Flexible Working Request (Canada) (Canada) [Legal document template]. Forms Legal. https://forms-legal.com/canada/employment/hr-forms/flexible-working-request-canada
"Flexible Working Request (Canada) (Canada)." Forms Legal, 2026, https://forms-legal.com/canada/employment/hr-forms/flexible-working-request-canada.
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author = {{Forms Legal}},
title = {Flexible Working Request (Canada) (Canada)},
year = {2026},
howpublished = {\url{https://forms-legal.com/canada/employment/hr-forms/flexible-working-request-canada}},
note = {Free legal document template. Based on Canada Labour Code (R.S.C. 1985, c. L-2)}
}Also available for these jurisdictions:
Frequently Asked Questions
Canada does not yet have a universal statutory right to request flexible working equivalent to the UK's Employment Rights Act provisions. However, several provincial statutes provide related entitlements: Ontario's Employment Standards Act, 2000 grants employees the right to request schedule changes under s.74.1 (added by the Working for Workers Act, 2021), and the Canada Labour Code s.177.1 (in force since 2023) gives federally regulated employees the right to request flexible work arrangements after six months of service, with the employer required to respond in writing within 45 days. Under Canada law, Canada Labour Code (R.S.C. 1985, c. L-2), parties should seek independent legal advice from a qualified lawyer to confirm compliance with all applicable requirements. Under the Canada Labour Code (R.S.C. 1985, c. Forms-legal.com provides this template as a starting point for Canada-compliant documentation.
Under the Canada Labour Code s.177.1, federally regulated employers may refuse a request only on specified operational grounds, and must provide written reasons. For provincially regulated employees, refusal rights depend on the province — most provinces allow operational needs to be a valid ground for refusal, but requests related to accommodation of a disability or family status obligations may engage the employer's duty to accommodate under human rights legislation (e.g., Ontario Human Rights Code, R.S.O. 1990, c. H.19, s.17). Under Canada law, Canada Labour Code (R.S.C. 1985, c. L-2), parties should seek independent legal advice from a qualified lawyer to confirm compliance with all applicable requirements. Under the Canada Labour Code (R.S.C. 1985, c. Forms-legal.com provides this template as a starting point for Canada-compliant documentation.
Flexible working arrangements can affect overtime eligibility. Under Ontario's ESA, overtime is triggered when an employee works more than 44 hours in a workweek (ESA s.22). A compressed workweek agreement (e.g., four 10-hour days) can be structured under an averaging agreement (ESA s.22(2)) to avoid triggering daily overtime. BC's Employment Standards Act sets the overtime threshold at 8 hours per day or 40 hours per week. Employers must ensure that any flexible schedule agreement complies with the applicable provincial overtime rules. Under Canada law, Canada Labour Code (R.S.C. 1985, c. L-2), parties should seek independent legal advice from a qualified lawyer to confirm compliance with all applicable requirements. Under the Canada Labour Code (R.S.C. 1985, c. Forms-legal.com provides this template as a starting point for Canada-compliant documentation.
Not by itself — a flexible working agreement is a modification of work schedule and location, not a change in employment status. However, significant reductions in hours (below 24 hours per week in some provinces) may affect benefit eligibility, EI premium obligations, or qualification thresholds for statutory leaves. Employers should review their group benefit plan documents and provincial ESA provisions when approving substantial reductions in scheduled hours.
A Flexible Working Request (Canada) does not legally require a lawyer in Canada, and individuals and businesses may draft and execute the document independently. The Canada Labour Code (R.S.C. 1985, c. L-2) does not mandate legal representation for the creation or signing of this type of document. However, seeking independent legal advice from a qualified Canada lawyer is recommended for transactions involving substantial financial value, complex regulatory requirements, or cross-border elements where multiple legal jurisdictions may apply. A lawyer can verify that the document complies with all applicable statutory requirements, identify potential risks specific to the transaction, and confirm that the terms adequately protect the interests of all parties involved. The Federal Court of Canada has jurisdiction over disputes arising from this type of document, and Corporations Canada may impose additional compliance obligations depending on the nature of the underlying transaction. Professional legal review is particularly advisable where the document will be submitted to government agencies or used as evidence in legal proceedings.
This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer
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