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WH380 F Certification of Health Care Provider for Family Members Serious Health Condition (Family and Medical Leave Act) U.S. Department of Labor Wage and Hour Division DO NOT SEND COMPLETED FORM
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How to fill out wh380 f
How to fill out wh380 f:
01
Gather the necessary information such as your personal details, employer information, and dates of leave.
02
Read the instructions on the form carefully to ensure you understand each section and its requirements.
03
Start by filling out your personal information accurately, including your name, address, and contact information.
04
Next, provide the name and address of your employer, along with their contact information.
05
Indicate the dates of your leave, including the start and end dates.
06
Fill out the section detailing the reason for your leave, whether it's due to your own serious health condition or to care for a family member.
07
Provide any additional information or documentation required, such as medical certification or supporting evidence.
08
Review the completed form for any errors or missing information, making sure all fields are properly filled out.
09
Sign and date the wh380 f form before submitting it to your employer.
Who needs wh380 f:
01
Employees who need to take a leave of absence due to their own serious health condition.
02
Employees who need to take a leave of absence to care for a family member with a serious health condition.
03
Employees who require medical documentation in order to be approved for their requested leave.
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What is wh380 f?
Wh380 f is a form required by the Department of Labor for employees to use when requesting medical certification for their own serious health condition or the serious health condition of a family member.
Who is required to file wh380 f?
Employees are required to file wh380 f when requesting medical certification for a serious health condition.
How to fill out wh380 f?
To fill out wh380 f, employees must provide their personal information, the type of leave requested, and medical certification from a healthcare provider.
What is the purpose of wh380 f?
The purpose of wh380 f is to provide documentation to support an employee's request for leave under the Family and Medical Leave Act (FMLA) for a serious health condition.
What information must be reported on wh380 f?
On wh380 f, employees must report their personal information, the health condition requiring leave, and medical certification from a healthcare provider.
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