The Family and Medical Leave Act of 1993 (FMLA) gives certain job protections to employees when balancing work responsibilities with the demands of personal illness or injury or in caring for family members.
FMLA Notice - Employee rights under the Family Medical Leave Act.
FMLA Leave Request Form - This form is used by an employee to formally request family or medical leave.
US Dept. of Labor Notice - This form is to inform employees of their rights and responsibilities. It is to be provided to employees within five days of learning of the need for leave.
WH380E - Employee must have his or her healthcare provider certify the employee’s own serious health condition. The employee is to have at least 15 days to return this.
WH380F - Employee to have his or her family member’s health care provider certify the family member’s serious health condition. The employee is to have at least 15 days to return this.
FMLA Declaration of Relationship - This form should be completed by the employee when the employee requests Family and Medical.
WH382- Designation Notice - Informs the employee whether the FMLA leave request is approved; also informs the employee of the amount of leave that is designated and counted against the employee’s FMLA entitlement. If you are going to require a fitness-for-duty certification, this requirement must be included.
FMLA Fitness For Duty Form - To obtain certification from a health care provider that an employee is able to resume work.
FMLA HIPAA Authorization Form - These authorizations are an individual’s signed permission to allow a covered entity to use or disclose the individual’s protected health information that is described in the authorization for the purpose(s), and to the recipient(s) stated in the authorization.