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Request for Family/Medical Leave of Absence Name Department Date of Hire Supervisor Phone Number Where you can be Reached While on Leave I am requesting a family/medical leave of absence. All requests
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To fill out a request for family medical leave, follow these steps:

Who needs request for familymedical leave?

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Employees who have a qualifying reason to take time off for their own serious health condition, the birth of a child, to care for a family member with a serious health condition, or for military caregiving and leave purposes, may need to request family medical leave.
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Request for familymedical leave is a formal application made by an employee to take time off work to care for a family member with a serious health condition.
Employees who are eligible for familymedical leave and need time off to care for a family member with a serious health condition are required to file the request.
Employees can fill out the request for familymedical leave by completing the required forms provided by their employer and submitting any necessary documentation.
The purpose of the request for familymedical leave is to allow employees to take time off work to care for a family member with a serious health condition without risking their job security.
The request for familymedical leave must include information such as the employee's name, the name of the family member needing care, the reason for the leave, and the expected duration of the leave.
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