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FACULTY SERIOUS HEALTH CONDITION REQUEST FOR FAMILY MEDICAL LEAVE OF Absence Provosts Office of Faculty Affairs is responsible for processing faculty requests for Family Medical Leave under PER 4.17
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How to fill out faculty medical leave request

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How to fill out faculty medical leave request

01
Obtain a faculty medical leave request form from the human resources department or your supervisor.
02
Fill out the personal information section of the form, including your name, employee ID, and faculty position.
03
Specify the start date and end date of your medical leave period.
04
Provide a detailed explanation of the medical condition that necessitates your leave, including any supporting documentation from a healthcare professional if required.
05
Indicate any requested accommodations or modifications to your work duties during your absence.
06
Sign and date the form.
07
Submit the completed form to the human resources department or your supervisor.

Who needs faculty medical leave request?

01
Faculty members who need to take a medical leave for health reasons.

What is Faculty Medical Leave Request - louisville.edu Form?

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A faculty medical leave request is a formal application submitted by faculty members to take time off due to medical reasons, which may include personal health issues or the need to care for a family member.
Faculty members who need to take medical leave are required to file a faculty medical leave request.
To fill out a faculty medical leave request, one must complete the designated form provided by their institution, including details such as the duration of the leave, the reason for the leave, and any required medical documentation.
The purpose of a faculty medical leave request is to formally document a faculty member's need for medical leave and ensure that proper procedures are followed to manage their absence.
The information that must be reported on a faculty medical leave request typically includes the faculty member's name, department, reason for leave, expected start and end dates, and any supporting medical documentation.
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