Family and Medical Leave Act (FMLA): Request for Leave Forms and Posted Notices

Employee Request for Leave (RF Form)

Employee Rights and Responsibilities Under FMLA - *Required Poster* (U.S. DOL Form WHD 1420)

Notice of Eligibility and Rights and Responsibilities - Employer Response to Employee Request for FMLA Leave (U.S. DOL Form WH-381)

Designation Notice (U.S. DOL Form WH-382)

Certification of Health Care Provider for Employee’s Serious Health Condition (U.S. DOL Form WH-380-E)

Certification of Health Care Provider for Family Member’s Serious Health Condition (U.S. DOL Form WH-380-F)

Certification of Qualifying Exigency For Military Family Leave (U.S. DOL Form WH-384)

Certification For Serious Injury or Illness of Covered Servicemember for Military Family Leave (U.S. DOL Form WH-385)

Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (U.S. DOL Form WH-385-V)

 

 

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