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CertificationofHealthCareProviderforEmployeesSerious
HealthConditionFamily andMedicalLeaveAct(WH380E)
SECTION I:
CompletedbytheEmployer:Medical certifications, recertifications, medicalhistoriesor
relateddocumentscreatedforFMLApurposesaretreatedasconfidentialmedicalrecordsand
aremaintainedinseparatefilesfromtheusualpersonnelfilesandinaccordancewith29
C.F.R.1630.14(c)(1),
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What is certification of health care?
Certification of health care is a document that verifies an individual's physical or mental health status.
Who is required to file certification of health care?
Individuals who are seeking medical treatment, applying for health insurance, or participating in certain programs may be required to file certification of health care.
How to fill out certification of health care?
Certification of health care can be filled out by a licensed healthcare provider, who will evaluate and document the individual's health status.
What is the purpose of certification of health care?
The purpose of certification of health care is to provide accurate information about an individual's health status for medical treatment, insurance coverage, or program eligibility.
What information must be reported on certification of health care?
Information reported on certification of health care may include medical history, current health conditions, medications, and treatment plans.
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