Family Medical Leave Act

The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.
To initiate a request for FMLA:

1. Complete the following request form:
   • FML Request Form
2. Select the appropriate form from the list below and submit to your healthcare provider (or other third party if applicable) for completion.
   • Certification of Health Care Provider for Employee’s Serious Health Condition
   • Certification of Health Care Provider for Family Member’s Serious Health Condition
   • Military Caregiver, Leave of an Active Duty Servicemember
   • Military Caregiver, Leave of a Veteran
   • Certification for Military Family Leave for U.S. Department of Labor Qualifying Exigency
3. Completed forms must be submitted to Human Resources for final approval.  Please contact Human Resources to initiate a request for FMLA.

To learn more about Family and Medical Leave Act, visit US Department of Labor website here.

Board Policy – Family and Medical Leave Act
Administrative Procedure – Family and Medical Leave Act