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Oregon and Federal Family and Medical Leave Health Care Provider CertificationThis form is to be completed by a health care provider and returned to the employee.Information sought on this form relates
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How to fill out information sought on this

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Read the form or document carefully to understand what information is being requested.
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Fill in each section or field with the requested information accurately and completely.
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Use black or blue ink if filling out a paper form, or type in the information if filling out an online form.
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Who needs information sought on this?

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Employers may need this information for payroll and tax purposes.
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Information sought may include data, documents, statistics, or other types of information that are being requested.
The specific requirements for who is required to file information sought will depend on the context and purpose of the request.
The process for filling out information sought will vary depending on the instructions provided by the requesting party.
The purpose of information sought is to gather relevant data or details for a specific purpose, such as research, analysis, or compliance.
The specific information that must be reported on information sought will be outlined in the request.
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