Get the free WH-380-F

Name: Fillable Online WH-380-F Fax Email Print - pdfFiller
Brand: pdfFiller
Rating: 4.2 (59 reviews)

Get Form

Show details

CERTIFICATION OF HEALTH CARE PROVIDER FOR FAMILY MEMBERS SERIOUS HEALTH CONDITION (FAMILY AND MEDICAL LEAVE ACT) OMB Control Number: 12150003 Form WH380F Expires 2/28/2015Section I: For Completion

We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign wh-380-f

Edit your wh-380-f form online

Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.

Add your legally-binding signature

Draw or type your signature, upload a signature image, or capture it with your digital camera.

Share your form instantly

Email, fax, or share your wh-380-f form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit wh-380-f online

Ease of Setup

pdfFiller User Ratings on G2

Ease of Use

pdfFiller User Ratings on G2

Follow the steps down below to take advantage of the professional PDF editor:

1

Log in. Click Start Free Trial and create a profile if necessary.

2

Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.

3

Edit wh-380-f. Replace text, adding objects, rearranging pages, and more. Then select the Documents tab to combine, divide, lock or unlock the file.

4

Get your file. When you find your file in the docs list, click on its name and choose how you want to save it. To get the PDF, you can save it, send an email with it, or move it to the cloud.

pdfFiller makes dealing with documents a breeze. Create an account to find out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.

Learn more about security & compliance

How to fill out wh-380-f

01

To fill out form WH-380-F, follow these steps:

02

Start by filling out the basic information at the top of the form, including your name, the name of the covered employee, and the date.

03

Provide the details of the health condition or injury that the employee is suffering from. Include the date of onset, the nature of the condition, and any treatment received.

04

Indicate whether the employee is able to perform their job duties or if they require any work restrictions.

05

If the employee has received medical treatment for their condition, provide the name and address of the healthcare provider.

06

Complete the certification section by signing and dating the form. This section should be completed by the employee's healthcare provider as well.

07

Make copies of the completed form for your records and provide a copy to the employee.

Who needs wh-380-f?

01

Form WH-380-F is needed by employers who have employees covered under the Family and Medical Leave Act (FMLA).

02

This form is specifically used for employees who need to take leave from work due to their own serious health condition or injury.

Fill form : Try Risk Free

Rate the form

4.2

Satisfied

59 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Can I sign the wh-380-f electronically in Chrome?

Yes. With pdfFiller for Chrome, you can eSign documents and utilize the PDF editor all in one spot. Create a legally enforceable eSignature by sketching, typing, or uploading a handwritten signature image. You may eSign your wh-380-f in seconds.

Can I edit wh-380-f on an iOS device?

Create, modify, and share wh-380-f using the pdfFiller iOS app. Easy to install from the Apple Store. You may sign up for a free trial and then purchase a membership.

Can I edit wh-380-f on an Android device?

You can make any changes to PDF files, such as wh-380-f, with the help of the pdfFiller mobile app for Android. Edit, sign, and send documents right from your mobile device. Install the app and streamline your document management wherever you are.

What is wh-380-f?

WH-380-F is a form used in the United States for requesting Family Leave benefits under the Family and Medical Leave Act (FMLA).

Who is required to file wh-380-f?

Employees who are seeking to take leave under the Family and Medical Leave Act (FMLA) for a serious health condition or to care for a family member with a serious health condition are required to file WH-380-F.

How to fill out wh-380-f?

To fill out WH-380-F, provide your personal information, details about the medical condition, the health care provider's information, and indicate the need for leave. Ensure that all sections are completed accurately and submit it to your employer.

What is the purpose of wh-380-f?

The purpose of WH-380-F is to document an employee's need for family leave due to a serious health condition, ensuring compliance with the FMLA requirements.

What information must be reported on wh-380-f?

WH-380-F requires information such as employee details, the relationship to the family member, the nature of the leave requested, and medical certification from a healthcare provider.

Fill out your wh-380-f online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now