Official form guide
This form is a template for employers to respond to employee requests for flexible working arrangements. It should be used when an employee makes a formal request to change their working hours, location, or pattern under Australian workplace laws.
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Form Overview
This form is a template for employers to respond to employee requests for flexible working arrangements. It should be used when an employee makes a formal request to change their working hours, location, or pattern under Australian workplace laws.
Plain English
This template helps employers properly respond when an employee asks to change how or where they work. It gives employers a structured way to consider the request and provide a written response, ensuring both parties understand the outcome.
Submission Date
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Employee requesting flexible work
Initiates the formal request process
✓ Ensure employee meets eligibility criteria
Employer approving with changes
Formalizes agreed changes
✓ Check if new terms require additional documentation
Employer refusing request
Provides written record of refusal
✓ Ensure refusal is based on valid business grounds
Dispute about request
Resolves disagreements through formal process
✓ Consider mediation before proceeding
Request for permanent change
Legally binds the new arrangement
✓ Update employment records and payslip details
Employers must respond to flexible working arrangement requests within 21 days of receiving them, unless the employer and employee agree to extend this timeframe.
Field map
Applicant
1 items
Full name (and representative, if any), postal address, email, and phone number of the person or organisation lodging the application.
Respondent
1 items
The exact legal name and ABN of the employer or other party the application is made against.
The Matter
2 items
Identify the kind of matter — for example, unfair dismissal, general protections, or an agreement application.
A clear description of what happened, relevant dates, and the outcome you are seeking.
Dates
1 items
Relevant dates such as the date of dismissal or the date the issue arose — these determine whether you are within time.
Supporting
1 items
Any documents that support your application, such as letters, contracts, or notices.
Declaration
1 items
Sign and date the form. Applications may also require a fee or an application for a fee waiver.
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Fillable formOpen in Editor->This template reflects current workplace legislation regarding flexible working arrangements, which may be subject to periodic review.
Quick Facts
Confusing the 21-day response timeframe with other workplace notice periods
Not understanding which requests qualify under workplace legislation
Uncertainty about what constitutes valid business reasons for refusal
Misunderstanding the difference between temporary and permanent flexible arrangements
Confusing this form with other workplace agreement forms
Uncertainty about record-keeping requirements for these responses
Not knowing when to involve HR or workplace relations specialists
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