Family Medical Leave Forms

Employees should contact Human Resources for counseling prior to completing these forms


Employee Rights and Responsibilities Under the Family Medical Leave Act

FMLA Information

Request for FMLA Form

Certification of Health Care Provider for Employee's Serious Health Condition

Certification of Health Care Provider for Family Member's Serious Health Condition

Certification for Serious Injury or Illness of Covered Servicemember for Military Family Medical Leave

Certification of Qualifying Exigency for Military Leave

Leave Without Pay & Insurance Continuation

Request for Sick Leave Pool Hours

Return to Work Status Form