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Certification of Health Care Provider for Employee California State University Family Medical Leave (CSU FM)*Employee Name: ___ SECTION I: For Completion by the HEALTH CARE PROVIDER INSTRUCTIONS:
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How to fill out csu family medical leave

01
Obtain the CSU Family Medical Leave form from HR department or online portal.
02
Fill out the employee information section including name, employee ID, and contact information.
03
Provide details of the family member requiring medical care or information on the employee's own medical condition.
04
Indicate the reason for the leave and the duration requested.
05
Obtain necessary medical documentation or certification from a healthcare provider.
06
Submit the completed form and supporting documents to HR for approval.

Who needs csu family medical leave?

01
Employees working for California State University (CSU) who need to take time off to care for a family member with a serious medical condition.
02
Employees who have a serious medical condition themselves and require time off for medical treatment and recovery.
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CSU Family Medical Leave is a program that allows eligible CSU employees to take up to 12 weeks of unpaid leave for certain family and medical reasons.
CSU employees who meet the eligibility criteria and need to take time off for family or medical reasons are required to file CSU Family Medical Leave.
CSU employees can fill out the CSU Family Medical Leave forms available on the CSU HR website and submit them to their supervisor and HR department.
The purpose of CSU Family Medical Leave is to provide job-protected leave for eligible employees to care for themselves or their family members during times of medical need.
CSU Family Medical Leave forms require information such as the reason for the leave, anticipated duration, and relevant supporting documentation.
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