Get Fmla Request Form

Completing the Family and Medical Leave Act (FMLA) request form online is a straightforward process that allows users to efficiently submit their requests for leave. This guide will walk you through each section of the form to ensure that you provide all necessary information accurately.

Follow the steps to complete your Fmla Request Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the 'Employee' section with your name, class title, department, position control number (PCN), supervisor’s name, date of hire, and the date you notified your supervisor of the leave request.
3. In the 'Reason for Leave' section, check all that apply. Options include adoption of a child, placement of a foster child, birth of a child, serious health condition of yourself, serious health condition of a spouse, child, or parent, qualifying exigency related to family military service, or being next of kin to a covered service member with a serious injury or illness.
4. Indicate the 'Type of Leave Requested' by selecting either continuous, intermittent, or reduced hours.
5. If the leave is approved, confirm whether you wish to use available sick leave and/or vacation time while on FMLA. Check 'Yes' or 'No' and specify which time off you wish to use.
6. Provide an explanation of the length and type of leave requested, including the expected start date of leave.
7. Sign the form either as the employee or as a representative, and include the date of the anticipated return to work.
8. Ensure the supervisor's signature is obtained along with the date.
9. Finally, the HR representative must sign and date the received section of the form.

Make sure to fill out and submit your documents online today.