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Family Medical Leave Act (FMLA)

Certification of Healthcare Provider for Employee's Serious Health Condition Form (PDF)

Certification of Healthcare Provider for Family Member's Serious Health Condition Form (PDF)

Certification of Qualifying Exigency for Military Family Leave (PDF)

Certification for Serious Injury or Illness of Covered Servicemember for Military Family Leave (PDF)

Designation Notice (PDF)

Employer Response to Employee Request for Family and Medical Leave (PDF)

Request for FMLA Leave (PDF)





Modified 7/24/2015
Article ID: 677