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MILWAUKEE FIRE DEPARTMENT12/18RETURN TO DUTY CERTIFICATION FOR FAMILY AND MEDICAL LEAVE ACT (FMLA) SECTION I EMPLOYEES NAME (LAST, FIRST, MIDDLE INITIAL) EMPLOYEES DEPARTMENTMILWAUKEE FIRE DEPARTMENT

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How to fill out fmla return to work-mfd

01

To fill out FMLA Return to Work-MFD form, follow these steps:

02

Obtain the FMLA Return to Work-MFD form from your employer or from the U.S. Department of Labor website.

03

Read the instructions provided on the form carefully to ensure you understand the requirements.

04

Fill in your personal information accurately, including your name, address, and contact details.

05

Specify the dates of your FMLA leave and the date you wish to return to work.

06

Indicate whether you need any work restrictions or accommodations upon your return.

07

If your healthcare provider has provided any related work restrictions, make sure to note them on the form.

08

Review the completed form to ensure all the information is accurate and complete.

09

Sign and date the form before submitting it to your employer.

10

Keep a copy of the filled form for your records.

11

Submit the form to your employer as per their instructions or guidelines.

Who needs fmla return to work-mfd?

01

FMLA Return to Work-MFD is needed by employees who have taken leave under the Family and Medical Leave Act (FMLA) and are ready to return to work. It is required for employees to communicate their intention of returning to work and any necessary work restrictions or accommodations they may need as a result of their family or medical leave.

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