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EMPLOYEE RIGHTS AND RESPONSIBILITIES UNDERTAKE FAMILY AND MEDICAL LEAVE EMPLOYEE ENTITLEMENT An eligible employee may take up to twelve weeks (26 weeks to care for a covered service member with a
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01
Download the WH-381 form from the official website of the US Department of Labor.
02
Fill out the employee's name, social security number, company name, and contact information.
03
Provide the date on which the leave started and the expected return date.
04
Enter the reason for the leave and whether it is a qualifying reason under the Family and Medical Leave Act.
05
Sign and date the form before submitting it to the employer.

Who needs wh-381 pdf - us?

01
Employees who are seeking leave under the Family and Medical Leave Act in the United States.

What is WH-381 (.pdf) - U.S. Department of Labor Form?

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The WH-381 form, also known as the Certification of Health Care Provider for Employee's Serious Health Condition, is used for employees to request time off under the Family and Medical Leave Act (FMLA) in the United States.
Employees who need leave for a serious health condition or to care for a family member with a serious health condition are required to file WH-381 form.
The WH-381 form must be completed by the employee and the health care provider. It requires information about the employee's health condition and the need for leave.
The purpose of the WH-381 form is to certify an employee's need for leave due to a serious health condition under the FMLA.
The WH-381 form requires information about the employee's health condition, the health care provider's information, and the expected duration of leave.
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