Get 11-09 Medical Cert Form - Cwa Local 1022 - Wall, Nj

This guide provides detailed instructions for users to complete the 11-09 Medical Cert Form online effectively. The process is designed to be straightforward, helping you submit the necessary information for FMLA leave with ease.

Follow the steps to fill out the form online successfully.

1. Click the 'Get Form' button to access the form and open it in your preferred online editor.
2. Begin by filling out Section A of the form, which requires you to provide your name, the date of your first absence, and your BAID number. Ensure that all entries are accurate to avoid delays.
3. Select the type of leave you are requesting by checking all applicable boxes, including new requests or extensions. Provide a brief explanation for the leave, ensuring clarity on whether it pertains to your own health condition or that of a family member.
4. Move on to Section B, which must be completed by your health care provider. It’s essential to supply sufficient medical facts to substantiate your request, including a diagnosis and treatment plan as required.
5. If applicable, include all necessary documentation to support your leave request, such as proof of birth for a newborn or adoption. Ensure that your health care provider's details and signature are complete in Section D.
6. Review the entire form for completeness and accuracy, ensuring no sections are left blank. Incomplete forms will be returned for revision, potentially affecting your leave timeline.
7. Once the form is complete, save the changes and prepare to submit it. You can choose to download and print it, or share it directly if the online system allows.
8. Submit the completed form via fax or mail to the appropriate processing center indicated for your region.

Make sure to complete and submit your 11-09 Medical Cert Form online today to ensure your leave is processed in a timely manner.