Checklists
Staff Leave Request
Letters and Notices
- Notice of Eligibility and Rights
- Declaration of Relationship
- Designation Notice
- Sample Letters Referenced in FML Guidelines
Note: All letters should be copied to Benefits
Certifications
- Certification of Health Care Provider for Employee's Serious Health Condition
- Certification of Health Care Provider for Family Member's Serious Health Condition
- Certification of Health Care Provider for Employee's Pregnancy Disability
- Certification of Qualifying Exigency for Military Family
- Certification of Health Care Provider for Military Caregiver Leave
- Return to Work Certification Form
Miscellaneous
- Exempt Employee Workweek Agreement for FML Leaves (Taken On A Reduced Schedule or Intermittent Basis)
- FMLA Intermittent Leave Tracking Sheet