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Form GBRIG-2 Certification of Health Care Provider for Family Member s Serious Health Condition Family and Medical Leave Act U.S. Department of Labor Wage and Hour Division OMB Control Number 1235-0003 Expires 2/28/2015 SECTION I For Completion by the EMPLOYER INSTRUCTIONS to the EMPLOYER The Family and Medical Leave Act FMLA provides that an employer may require an employee seeking FMLA protections because of a need for leave to care for a covered family member with a serious health...
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