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Family and Medical Leave (FMLA) Information and Forms  

Family and Medical Leave Act Guide - This booklet contains information on FMLA including a description of the program, definitions of terms, eligibility information, information on how the program works and what to do if you need to use Family and Medical Leave. This is a Microsoft Word document

Family and Medical Leave Notification Form - Form required to notify Employee Benefits Division not to cut off health benefits

FMLA410 - Request form for Family and Medical Leave
FMLA411 - Family and Medical Leave Certification of Health Care Provider Form
FMLA412 - Response Form for Employee Request for Family and Medical Leave
FMLA413 - Family and Medical Leave Return to Work Form


March, 2008