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COUNTY OF ALAMEDA FAMILY AND MEDICAL LEAVES CERTIFICATION OF HEALTH CARE PROVIDER (Employee/Family Member) Instructions for Employee: Pursuant to the Family and Medical Leave Act (FMLA), California

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How to fill out family and medical leaves

01

Obtain the necessary forms: Contact your employer or the human resources department to obtain the family and medical leave forms.

02

Read through the forms: Take your time to thoroughly read and understand the instructions on the forms before filling them out.

03

Provide personal information: Fill in your personal details such as your name, employee ID, and contact information.

04

Specify the reason for leave: Indicate the reason for your family and medical leave, whether it's taking care of a sick family member, your own illness, or the birth/adoption of a child.

05

Provide supporting documentation: Attach any required medical documents or certification to support your leave request.

06

Fill in the dates: Specify the start and end dates for your leave period.

07

Sign and date the forms: Make sure to sign and date the completed forms before submitting them.

08

Submit the forms: Deliver the filled-out forms to the appropriate department or person as instructed by your employer.

09

Follow up: After submitting the forms, follow up with your employer or HR department to track the progress of your leave request.

10

Understand your rights and responsibilities: Familiarize yourself with the policies and regulations regarding family and medical leave to ensure you are aware of your rights and responsibilities during your leave period.

Who needs family and medical leaves?

01

Employees who are experiencing a serious health condition and need time off work to seek treatment, recover, or undergo medical procedures.

02

Employees who need to care for a family member with a serious health condition.

03

Employees who have recently given birth to a child or need time off for the adoption or foster care placement of a child.

04

Employees who need to attend to certain military family leave situations such as taking time off to care for a covered service member or to handle certain matters arising from a family member's military deployment.

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What is family and medical leaves?

Family and medical leaves are job protected leaves that allow employees to take time off work for family and medical reasons.

Who is required to file family and medical leaves?

Employees who are eligible for family and medical leave under the law are required to file for it.

How to fill out family and medical leaves?

Employees can fill out family and medical leave forms provided by their employer or the relevant government agency.

What is the purpose of family and medical leaves?

The purpose of family and medical leaves is to give employees time off work to take care of their own health issues or to care for a family member in need.

What information must be reported on family and medical leaves?

Employees must report information such as the reason for the leave, the anticipated duration of the leave, and any supporting documentation.

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