Family Medical Leave Act (FMLA)

Request for FMLA

 Request For FMLA 

To be completed by Employee and submitted to Human Resources.

 

Certification of Health Care Provider for Employee

 FMLA - Form For Employee
To be completed by the Health Care Provider and submitted to Human Resources.

Certification of Healthcare Provider for a Family Member

FMLA - Form For Family Member
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)

 FMLA - Form For Military Member
To be completed by the Health Care Provider(as specified in Section II) and submitted to Human Resources.