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FMLA Forms
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FMLA Designation Notice Under the Family and Medical Leave Act – Form WH-382Informs the employee whether the FMLA leave request is approved.
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FMLA Notice of Eligibility & Rights and Responsibilities Under the Family and Medical Leave Act – Form WH-381Informs the employee of the specific expectations and obligations associated with the FMLA leave request and the consequences of failure to meet those obligations.
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FMLA Certification for Serious Injury or Illness of a Current Service Member for Military Caregiver Leave – Form WH-385For use when requesting leave to care for a family member who is a current service member with a serious injury or illness.
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FMLA Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave – Form WH-385-VFor use when requesting leave to care for a family member is who a covered veteran with a serious injury or illness.
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FMLA Certification for Military Family Leave for Qualifying Exigency – Form WH-384For use when a leave request arises out of the foreign deployment of the employee’s spouse, son, daughter, or parent.
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FMLA Employee’s Serious Health Condition – Certification Form WH-380-E, BilingualUse when employees request leave for their own medical condition.
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FMLA Family Member’s Serious Health Condition – Certification Form WH-380-F, BilingualUse when a leave request is due to the medical condition of the employee’s family member.
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