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EMERGENCY FAMILY AND MEDICAL LEAVE EXPANSION REQUEST FORM (FLEA)PART I EMPLOYEE INFORMATION (Fill in info and check the option that applies) Name: V#: Department: Employee Email: Supervisor Email:

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How to fill out emergency family and medical

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To fill out emergency family and medical forms:

02

Gather all necessary information about your family members such as their full names, dates of birth, and contact details.

03

Prepare any relevant medical information like allergies, current medications, and medical conditions for each family member.

04

Obtain emergency contact information for each family member, including their names, phone numbers, and relationships.

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Locate the emergency family and medical forms, which are usually available online or from your employer or healthcare provider.

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Make copies of the completed forms for your records and keep the originals in a safe and easily accessible location.

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Update the forms whenever there are any changes in your family's medical information or emergency contacts.

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Inform your family members and emergency contacts about the existence and location of these forms, so they can be accessed quickly in case of an emergency.

Who needs emergency family and medical?

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Emergency family and medical forms are important for individuals or families who want to be prepared for unexpected situations.

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They are particularly useful for:

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- Parents or guardians who have children under their care

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Having these forms filled out can help healthcare providers and emergency responders provide the necessary care and contact the right individuals in case of any medical emergencies or accidents.

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What is emergency family and medical?

Emergency Family and Medical Leave (EFML) is a federal program that provides eligible employees with paid leave for specified reasons related to COVID-19.

Who is required to file emergency family and medical?

Employees who need to take leave to care for a child whose school or place of care is closed due to COVID-19.

How to fill out emergency family and medical?

Employees can request EFML by filling out the appropriate forms provided by their employer and providing supporting documentation.

What is the purpose of emergency family and medical?

The purpose of EFML is to provide paid leave for eligible employees to care for their children during the COVID-19 pandemic.

What information must be reported on emergency family and medical?

Employees must provide documentation proving the closure of their child's school or place of care due to COVID-19.

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