Skip to content

Leave of Absence

 
 
 

Leave of Absence Forms

Description

Castastrophic Leave Donor Form use form to donate vacation time to fellow employees who have exhausted their leave options or to donate accrued vacation time to the castastrophic leave donation bank.
Castastrophic Leave Recipient Application Request Form use form to initiate the process
Declaration of Relationship This form is use to help ensure the relationship is FML eligible when employees are eligible for family medical leave
Intermittent Tracking Form employee use to track intermittent usage of FML 
Leave of Absence Checklist For employee use to help through the leave of absence process
Leave of Absence Request Form employee use to request an leave of absence 
Medical Certification for Employee employee requesting FML for themselves 
Medical Certification for Employee's Pregnancy Disability employee requesting PDL due to pregnancy, childbirth, or related medical condition
Medical Certification for Family Member employee requesting FML to care for a family member
Return to Work Certification  health care provider completes form alllowing employee to return to work after FML