Get the free WH-380-E.pdf

Certification of Health Care Provider for Employees Serious Health Condition (Family and Medical Leave Act)U.S. Department of Labor Wage and Hour Division DO NOT SEND COMPLETED FORM TO THE DEPARTMENT

How to fill out wh-380-epdf

How to fill out wh-380-epdf

1. To fill out the WH-380-E PDF form, follow these steps:
2. Open the WH-380-E PDF form on your computer.
3. Enter the relevant employee and employer information in the designated fields. This may include the employee's name, job title, and contact details, as well as the employer's name and address.
4. Provide the dates of the requested leave, including the starting and ending dates.
5. Indicate the reason for the leave, such as the employee's own serious health condition or the need to care for a family member with a serious health condition.
6. Attach any applicable medical documentation as required.
7. Review the completed form for accuracy and completeness.
8. Save the filled-out form on your computer.
9. Print a copy for your records and submit the form to the appropriate entity as specified by your employer's policies or the relevant authority.

Who needs wh-380-epdf?

1. The WH-380-E PDF form is required for employees who are eligible for leave under the Family and Medical Leave Act (FMLA) and need to request medical leave for their own serious health condition or to care for a family member with a serious health condition.
2. This form is typically needed by employees of covered employers who meet certain eligibility criteria, such as having worked for the employer for at least 12 months and having worked at least 1,250 hours in the past 12 months.

For pdfFiller’s FAQs

How can I edit wh-380-epdf from Google Drive?

It is possible to significantly enhance your document management and form preparation by combining pdfFiller with Google Docs. This will allow you to generate papers, amend them, and sign them straight from your Google Drive. Use the add-on to convert your wh-380-epdf into a dynamic fillable form that can be managed and signed using any internet-connected device.

How can I get wh-380-epdf?

It’s easy with pdfFiller, a comprehensive online solution for professional document management. Access our extensive library of online forms (over 25M fillable forms are available) and locate the wh-380-epdf in a matter of seconds. Open it right away and start customizing it using advanced editing features.

How do I complete wh-380-epdf online?

With pdfFiller, you may easily complete and sign wh-380-epdf online. It lets you modify original PDF material, highlight, blackout, erase, and write text anywhere on a page, legally eSign your document, and do a lot more. Create a free account to handle professional papers online.