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6 Questions? Call Vicki 860-486-0411 Must be submitted within 30 days of foreseeable leave, if leave is FMLA qualifying. Form #: P33A - Employee Revision Date: 12/2010 AGENCY INSTRUCTIONS To be used by employee who is absent for personal illness, including FMLA absences. This medical certificate is to be used by an employee who is or will be absent for health reasons including the birth of a child. It shall be given to the employee or sent directly to his physician or practitioner. The name o.
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