
Get the free FAMILY AND MEDICAL LEAVE FML - University of California
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Print Form RETURN TO WORK CERTIFICATION For Family and Medical Leave (FM) SECTION I To be completed by THE EMPLOYER EMPLOYEE IS NAME (LAST, FIRST, MIDDLE INITIAL) EMPLOYEE IS DEPARTMENT CONTACT Kerry
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How to fill out family and medical leave

How to fill out family and medical leave:
01
Determine eligibility: Before filling out the family and medical leave form, it's important to determine if you are eligible for this type of leave. Generally, employees who have worked for at least 12 months for a covered employer are eligible for this leave. Additionally, the leave can be taken for various reasons such as the birth or adoption of a child, a serious health condition, or to care for a family member with a serious health condition.
02
Obtain the necessary forms: Contact your employer or human resources department to obtain the required forms for family and medical leave. These forms may vary depending on your employer and the laws in your jurisdiction.
03
Fill out personal information: Start by providing your personal information, including your name, address, contact details, and the date of your request for leave. Make sure to provide accurate information to avoid any delays or issues with your application.
04
Specify the reason for leave: Indicate the reason for your family and medical leave. You may need to provide details about the medical condition, the anticipated duration of the leave, and any medical certifications or documentation required by your employer.
05
Determine the duration of leave: Specify the length of leave you are requesting. This could be a specific number of days or weeks, or you may be requesting intermittent leave over a certain time period. Ensure you follow your employer's policies and any legal requirements regarding the duration of leave.
06
Provide any additional documentation: Depending on the specific circumstances, you may need to attach supporting documentation to your family and medical leave request. This could include medical certificates, birth or adoption certificates, or any other relevant documents as per your employer's guidelines.
07
Submit the completed form: Once you have filled out all the necessary information, review the form to ensure accuracy and completeness. Sign and date the form as required, and submit it to your employer or human resources department within the designated timeframe.
Who needs family and medical leave?
01
Employees expecting or welcoming a new child: Family and medical leave is often necessary for employees who are expecting the birth or adoption of a child. This allows them time to bond with the new addition to their family.
02
Employees with a serious health condition: Individuals who have a serious health condition that requires medical treatment, hospitalization, or ongoing care may need to take family and medical leave to focus on their health and recovery.
03
Employees caring for a family member: Family and medical leave is also essential for employees who need to care for a family member with a serious health condition. This could include providing assistance, support, or attending medical appointments for their loved ones.
04
Employees dealing with certain military family situations: In some cases, employees may require family and medical leave related to various military family situations such as deployment, a serious illness or injury suffered by a service member, or making arrangements for a family member called to active duty.
05
Employees dealing with emergencies or unforeseen circumstances: Family and medical leave can also be used by employees who are faced with unexpected emergencies or unforeseen circumstances that require their immediate attention or presence.
Overall, family and medical leave is crucial for individuals who need time away from work to address significant life events, personal health issues, or to attend to the needs of their family members.
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What is family and medical leave?
Family and medical leave is a type of leave that allows employees to take time off work for personal or family medical reasons.
Who is required to file family and medical leave?
Employers are required to provide family and medical leave to eligible employees.
How to fill out family and medical leave?
Employees need to request family and medical leave from their employer and fill out the necessary forms.
What is the purpose of family and medical leave?
The purpose of family and medical leave is to allow employees to take time off work for medical reasons without risking their job security.
What information must be reported on family and medical leave?
Employees may need to report their reason for taking leave, the duration of the leave, and any supporting documentation.
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