Family and Medical Leave Act Request Form

Family and Medical Leave Act Request Form

Family and Medical Leave Act Request Form is a 2-page legal document that was released by the U.S. Department of Labor on November 1, 2012 and used nation-wide.

FAQ

Q: What is the Family and Medical Leave Act (FMLA)?A: The FMLA is a federal law that allows eligible employees to take unpaid leave for certain family and medical reasons.

Q: Who is eligible for FMLA leave?A: Employees who have worked for a covered employer for at least 12 months and have worked at least 1,250 hours in the past 12 months.

Q: What are some reasons for taking FMLA leave?A: Some reasons include the birth or adoption of a child, caring for a seriously illfamily member, or the employee's own serious health condition.

Q: How much leave can an employee take under FMLA?A: An eligible employee can take up to 12 weeks of unpaid leave within a 12-month period, with a few exceptions.

Q: What protections does FMLA provide?A: FMLA provides job protection, continuation of health insurance coverage, and the right to return to the same or an equivalent position after the leave.

Q: What is the FMLA Request Form used for?A: The FMLA Request Form is used by employees to formally request FMLA leave from their employer.

Q: What information is required on the FMLA Request Form?A: The form typically requires information such as the employee's name, reason for leave, dates of leave, and supporting documentation if applicable.

Q: Is FMLA leave paid?A: FMLA leave is generally unpaid, but employees can choose to use any accrued paid leave (such as vacation or sick leave) during their FMLA leave period.

Q: Can employers deny FMLA requests?A: Employers can deny FMLA requests if the employee does not meet the eligibility requirements or fails to provide the required documentation.

ADVERTISEMENT

Form Details:

  • The latest edition currently provided by the U.S. Department of Labor;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more legal forms and templates provided by the issuing department.

Download Family and Medical Leave Act Request Form

4.6 of 5 (18 votes)
  • Family and Medical Leave Act Request Form

    1

  • Family and Medical Leave Act Request Form, Page 2

    2

  • Family and Medical Leave Act Request Form, Page 1
  • Family and Medical Leave Act Request Form, Page 2
Prev 1 2 Next
ADVERTISEMENT

Related Documents