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THE ENLARGED CITY SCHOOL DISTRICT OF TROY Human Resource DepartmentEMPLOYEE REQUEST FOR FAMILY MEDICAL LEAVE ACT FORM Date___ Position ___Employees Name___ Building ___1. Reason for requested leave:
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Obtain the form family and medical from the appropriate source (such as HR department or online portal).
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Read the instructions carefully to understand the information needed.
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Fill out the personal details section including name, address, contact information, and employee ID.
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Provide information on the family member or medical condition being addressed.
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Include any necessary documentation or evidence to support the request.
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Review the completed form for accuracy and make any necessary corrections.
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Submit the form to the designated individual or department as per the instructions provided.

Who needs form family and medical?

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Employees who require leave for family reasons or medical conditions.
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Employers who need to document and approve requests for family or medical leave.
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Form family and medical refers to the Family and Medical Leave Act (FMLA) forms used to request leave for qualifying family or medical reasons.
Eligible employees of covered employers, typically those with 50 or more employees, are required to file the form if they wish to take FMLA leave.
To fill out the form, employees must provide details about their need for leave, including personal information, the nature of the medical condition, and supporting documentation if needed.
The purpose of the form is to formally request leave under the FMLA and ensure that the employer is notified of the reasons for the leave.
The form must report employee details, the relationship to the family member, duration of the leave, and medical information relevant to the condition necessitating the leave.
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