PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form WH-380-F
for the current year.
Form WH-380-F Certification of Health Care Provider for Family Member's Serious Health Condition (Family and Medical Leave Act)
What Is Form WH-380-F?
This is a legal form that was released by the U.S. Department of Labor - Wage and Hour Division on May 1, 2015 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form WH-380-F?A: Form WH-380-F is a Certification of Health Care Provider for Family Member's Serious Health Condition.
Q: What is the purpose of Form WH-380-F?A: The purpose of Form WH-380-F is to gather information about a family member's serious health condition for the Family and Medical Leave Act (FMLA).
Q: Who can use Form WH-380-F?A: Employees who need to take leave under the FMLA to care for a family member with a serious health condition can use Form WH-380-F.
Q: What information is required on Form WH-380-F?A: Form WH-380-F requires information about the family member's health condition, the need for leave, and the expected duration of the condition.
Q: Is Form WH-380-F mandatory?A: Yes, Form WH-380-F is mandatory for employees applying for FMLA leave to care for a family member's serious health condition.
Form Details:
- Released on May 1, 2015;
- The latest available edition released by the U.S. Department of Labor - Wage and Hour Division;
- Easy to use and ready to print;
- Yours to fill out and keep for your records;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form WH-380-F by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the U.S. Department of Labor - Wage and Hour Division.
Download Form WH-380-F Certification of Health Care Provider for Family Member's Serious Health Condition (Family and Medical Leave Act)
1
2
3
4
