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FAIR EMPLOYMENT & HOUSING COMMISSION CERTIFICATION OF HEALTH CARE PROVIDER (California Family Rights Act of 1993 (CFA)) CSU REVISED JUNE 2011 1. Employees Name: 2. Patients Name (If other than employee):
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How to fill out cfra medical certification bformb
How to fill out cfra medical certification bformb:
01
Start by accessing the cfra medical certification bformb. You can usually find it on the website of the organization or entity that requires this certification.
02
Carefully read the instructions provided on the form to understand the information and documentation required.
03
Begin by filling out your personal information accurately. This includes your full name, address, contact details, and any other requested information.
04
If applicable, provide the details of your employer or company, including their name and contact information.
05
Next, you will need to provide information about your medical condition. This might include the diagnosis, treatment plan, and any medical restrictions or accommodations required.
06
If necessary, provide the names and contact information of any healthcare providers or professionals who have treated or are currently treating you.
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Be sure to sign and date the form, as well as provide any additional documentation or supporting evidence as required.
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Finally, review the completed form for accuracy and completeness before submitting it according to the instructions provided.
Who needs cfra medical certification bformb:
01
Employees who need to take medical leave under the California Family Rights Act (CFRA) may need to submit the cfra medical certification bformb.
02
Employers may require this form to verify the eligibility and necessity of the employee's medical leave request.
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Healthcare providers or professionals may need to fill out this form to provide documented evidence of the employee's medical condition and treatment.
Remember, it's always best to consult with your employer or HR department for specific instructions and requirements regarding the cfra medical certification bformb.
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