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CERTIFICATION OF HEALTH CARE PROVIDER FOR EMPLOYEES SERIOUS HEALTH CONDITION (FAMILY AND MEDICAL LEAVE ACT) Section I: For Completion by the EMPLOYER INSTRUCTIONS to the EMPLOYER: The Family and Medical

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Individuals who require leave for family and medical reasons.

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What is form family and medical?

Form family and medical, also known as FMLA (Family and Medical Leave Act), is a federal law that provides eligible employees with unpaid, job-protected leave for specified family and medical reasons.

Who is required to file form family and medical?

Employers are required to provide employees with the necessary paperwork to file for FMLA leave, and employees are required to complete the form and submit it to their employer.

How to fill out form family and medical?

Employees must provide their personal information, details about the reason for their leave, and any relevant medical documentation in order to fill out the form family and medical.

What is the purpose of form family and medical?

The purpose of form family and medical is to protect employees who need to take time off work for family or medical reasons and ensure that they have job security while on leave.

What information must be reported on form family and medical?

Employees must report their personal information, the reason for their leave, the duration of their leave, and any relevant medical documentation.

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