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This document provides a checklist and procedural guidelines for employees at the University of Washington seeking to request a leave of absence or modified work schedule due to personal or family

How to fill out family and medical leave

How to fill out family and medical leave

1. Obtain the Family and Medical Leave Act (FMLA) form from your employer or the Department of Labor website.
2. Read the instructions carefully to understand the eligibility requirements.
3. Fill out the employee information section with your name, address, and contact details.
4. Indicate the reason for the leave, such as a serious health condition, care for a family member, or birth/adoption of a child.
5. Specify the dates for the leave, including the start and end dates.
6. If applicable, provide medical certification from a healthcare provider to support your leave request.
7. Submit the completed form to your employer's HR department and keep a copy for your records.
8. Follow up with your employer to ensure your request has been processed.

Who needs family and medical leave?

1. Employees who have a serious health condition requiring time off.
2. Parents needing to care for a newborn, adopted, or foster child.
3. Individuals caring for an ill family member, such as a spouse, child, or parent.
4. Employees facing situations related to military family leave.

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What is family and medical leave?

Family and medical leave refers to a provision under the Family and Medical Leave Act (FMLA) that allows eligible employees to take unpaid, job-protected leave for specific family and medical reasons.

Who is required to file family and medical leave?

Employees who have worked for their employer for at least 12 months and have accumulated a minimum of 1,250 hours of service in the previous 12 months are required to file for family and medical leave.

How to fill out family and medical leave?

To fill out family and medical leave, employees must provide a completed application form to their employer, along with any required medical certifications or documentation supporting their request for leave.

What is the purpose of family and medical leave?

The purpose of family and medical leave is to allow employees to take time off to care for a family member with a serious health condition, to recover from their own serious health condition, or to handle family-related matters such as the birth or adoption of a child.

What information must be reported on family and medical leave?

Employers must report basic details such as the employee's name, the dates of leave, the reason for leave, and any required medical documentation to substantiate the need for family or medical leave.