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Texas Department of Criminal Justice DOL FORM WH-380-F An employee taking family medical leave (FM) for the serious health condition of a family member may obtain the Certification of Health Care

How to fill out wh 380 f form

To fill out DOL form WH-380-F, follow these steps:

1. Start by downloading the form from the official website of the U.S. Department of Labor (DOL) or obtain a physical copy from your employer or human resources department.
2. Begin filling out the form by providing your personal information in section 1, including your name, contact information, and employee identification details.
3. In section 2, you will need to provide the leave information. This includes the start and end dates of the leave and any intermittent leave schedule if applicable.
4. Section 3 requires you to specify the reason for the leave. Choose the appropriate reason from the provided options such as your own serious health condition, the serious health condition of a family member, or a qualifying exigency under the Family and Medical Leave Act (FMLA).
5. If you are taking leave due to a serious health condition, section 4 requires you to provide relevant medical information. This may include the healthcare provider's name and contact information, a description of the condition, and any treatment being received.
6. In section 5, you will need to indicate whether you are requesting paid leave, using accrued paid leave, or taking unpaid leave during this period.
7. If you are requesting leave to care for a family member, section 6 requires you to provide additional information about the family member, such as their relationship to you and their medical condition.
8. In section 7, you need to indicate whether you have already provided sufficient medical certification or if it will be provided at a later date.
9. Section 8 requires you to provide a statement indicating that the information provided is true and complete to the best of your knowledge.
10. Finally, sign and date the form in section 9.
11. Keep a copy of the filled-out form for your records and submit the original to your employer or human resources department as per their instructions.

Who needs DOL form WH-380-F:

Employers and employees involved in the Family and Medical Leave Act (FMLA) process need DOL form WH-380-F. This form is used to document and verify an employee's need for leave due to their own serious health condition or to care for a family member with a serious health condition. Both the employer and the employee have a role in completing this form accurately and timely to establish eligibility and comply with the FMLA regulations.

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What is dol form wh-380-f?

DOL Form WH-380-F is the Certification of Health Care Provider for Family Member's Serious Health Condition form.

Who is required to file dol form wh-380-f?

Employees are required to file DOL form WH-380-F when requesting leave for a family member's serious health condition under the Family and Medical Leave Act (FMLA).

How to fill out dol form wh-380-f?

To fill out DOL form WH-380-F, the employee must provide their personal information, the family member's health condition information, and certification from a health care provider.

What is the purpose of dol form wh-380-f?

The purpose of DOL form WH-380-F is to certify the family member's serious health condition and validate the need for FMLA leave for the employee.

What information must be reported on dol form wh-380-f?

The DOL form WH-380-F must include the employee's and family member's personal information, details of the health condition, and certification from a health care provider.