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What is CUNY FMLA Form

The CUNY Family and Medical Leave Request Form is a leave request document used by eligible employees of The City University of New York to request up to 12 weeks of unpaid job-protected leave for family and medical reasons.

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CUNY FMLA Form is needed by:
  • CUNY employees seeking family or medical leave
  • Human Resources personnel at CUNY
  • Healthcare providers completing the form
  • Supervisors managing employee leave requests
  • Benefits coordinators reviewing leave requests

How to fill out the CUNY FMLA Form

  1. 1.
    Access the CUNY Family and Medical Leave Request Form on pdfFiller by searching for the form name in the template library.
  2. 2.
    Open the form to view all available fields. Familiarize yourself with the layout, which includes sections for personal information and leave details.
  3. 3.
    Before starting, gather essential information such as your full name, job title, reason for leave, and intended start and end dates.
  4. 4.
    Utilize the fillable fields on pdfFiller to input your details clearly. Click on each field to type your responses directly into the form.
  5. 5.
    Select the appropriate reasons for your leave using the checkboxes. If needed, be prepared to attach supporting documentation like a medical certificate.
  6. 6.
    Ensure that you sign the form in the designated area after reviewing your information. Remember to make a statement of understanding about the leave terms.
  7. 7.
    Once you have filled in all relevant fields, take a moment to review the entire form for accuracy and completeness.
  8. 8.
    Save your changes on pdfFiller to keep a copy of the completed form. You can also download it as a PDF for your records or prepare it for submission.
  9. 9.
    Finally, submit the completed form to your Human Resources Director or Personnel Officer as discussed in the guidelines, preferably 30 days in advance.
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FAQs

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Eligible employees of The City University of New York can use the CUNY Family and Medical Leave Request Form to request leave under the CUNY FMLA Policy.
It is advisable to submit the completed CUNY Family and Medical Leave Request Form at least 30 days in advance of the anticipated leave to ensure proper processing.
The completed form should be submitted to your Human Resources Director or Personnel Officer, who will guide you through the next steps in the leave process.
Depending on the reason for your leave, you may need to provide supporting documents such as a medical certification, especially if your leave is for health-related issues.
Avoid leaving blank fields, failing to sign the document, or not providing adequate supporting information, which may delay the processing of your leave request.
Processing times can vary, but it is typically advisable to allow several weeks for review after submission. Check with your Human Resources for specific timelines.
If you need to make changes after submission, contact your Human Resources Director or Personnel Officer as soon as possible for further instructions.
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