Employee’s serious health condition, form WH-380-E - Use when a leave request is due to the medical condition of the employee. Family member’s serious health condition, form WH-380-F - Use when a …

The current FMLA Medical Certification Form for Employee’s Serious Health Condition - WH-380-E permits, but does not require, that the healthcare provider include a diagnosis.

INSTRUCTIONS to the EMPLOYER: The Family and Medical Leave Act (FMLA) provides that an employer may require an employee seeking FMLA protections because of a need for leave due to a …

Please click on the form needed below and print off a hard copy to proceed with your FMLA documentation.

For FMLA purposes, a “serious health condition” means an illness, injury, impairment, or physical or mental condition that involves inpatient care or continuing treatment by a health care provider. For …

For FMLA purposes, a “serious health condition” means an illness, injury, impairment, or physical or mental condition that involves inpatient care or continuing treatment by a health care provider. For …

mily member or his/her medical provider. The FMLA permits an employer to require that you submit a timely, complete, and sufficient medical certification to support a request for FMLA leave to care for a …

INSTRUCTIONS to the EMPLOYER: The Family and Medical Leave Act (FMLA) provides that an employer may require an employee seeking FMLA protections because of a need for leave due to a …

For FMLA purposes, a “serious health condition” means an illness, injury, impairment, or physical or mental condition that involves inpatient care or continuing treatment by a health care provider. For …

Information about the FMLA may be found on the WHD website at www.dol.gov/agencies/whd/fmla. Either the employee or the employer may complete Section I.