Forms and Documents

Electronic Family Medical Leave (eFMLA)

Request for FMLA

 Request For FMLA 

To be completed by Employee and submitted to Human Resources.

 

Certification of Health Care Provider for Employee

 FMLA - Employee Certification Form  

To be completed by the Health Care Provider and submitted to Human Resources.

Certification of Healthcare Provider for a Family Member

FMLA - Family Member Certification Form
To be completed by the Health Care Provider and submitted to Human Resources.

Certification for Military Family Leave (Serious Injury or Illness of Covered Service member)f

 FMLA  - Current Service Member Certification Form

To be completed by the Health Care Provider(as specified in Section II) and submitted to Human Resources.

 

Certification of Health Care Provider for a Veteran

 FMLA - Veteran Certification Form 

To be completed by the Health Care Provider and submitted to Human Resources.

Other Employee Forms