Form FMLA-HR1 Employee Request for Family and Medical Leave Entitlements - Connecticut

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Form FMLA-HR1 Employee Request for Family and Medical Leave Entitlements - Connecticut

What Is Form FMLA-HR1?

This is a legal form that was released by the Connecticut Department of Administrative Services - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is FMLA-HR1?
A: FMLA-HR1 is the form that employees in Connecticut use to request family and medical leave entitlements.

Q: Who can use FMLA-HR1?
A: Employees in Connecticut who are eligible for family and medical leave under the Family and Medical Leave Act (FMLA) can use FMLA-HR1.

Q: What is the purpose of FMLA-HR1?
A: The purpose of FMLA-HR1 is to request leave for a qualifying reason under the FMLA.

Q: What information is required on FMLA-HR1?
A: FMLA-HR1 requires information such as the employee's name, employer's name, the reason for the leave, the dates of the requested leave, and any supporting documentation.

Q: What happens after submitting FMLA-HR1?
A: After submitting FMLA-HR1, the employer will review the request and determine whether the employee is eligible for FMLA leave.

Q: Can FMLA-HR1 be used for personal leave?
A: FMLA-HR1 can be used for personal leave if it qualifies as a serious health condition or if the employee needs to care for a family member with a serious health condition.

Q: What is a serious health condition under FMLA?
A: A serious health condition under FMLA is an illness, injury, impairment, or physical or mental condition that requires inpatient care or continuing treatment by a healthcare provider.

Q: Are all employers required to provide FMLA leave?
A: No, not all employers are required to provide FMLA leave. The FMLA applies to employers with 50 or more employees within a 75-mile radius.

Q: Is FMLA leave paid?
A: FMLA leave is generally unpaid, but employees may be able to use accrued paid leave such as sick or vacation days during their FMLA leave.

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Form Details:

  • Released on March 1, 2018;
  • The latest edition provided by the Connecticut Department of Administrative Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form FMLA-HR1 by clicking the link below or browse more documents and templates provided by the Connecticut Department of Administrative Services.

Download Form FMLA-HR1 Employee Request for Family and Medical Leave Entitlements - Connecticut

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