We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Fmla Application

Get Fmla Application

APPLICATION FOR LEAVE OF ABSENCE EMPLOYEE APPLICATION This packet must be completed in its entirety as far in advance as possible; at least 30 days for a foreseeable leave, or as soon as practicable.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Fmla Application online

Completing the Family and Medical Leave Act (FMLA) application online is an important step for users needing to secure time off for medical or family reasons. This guide provides clear instructions and helpful tips for filling out the FMLA application effectively and accurately.

Follow the steps to complete your Fmla application online.

  1. Click the 'Get Form' button to obtain the Fmla application and open it in your online editor.
  2. Fill in your personal information in the 'Employee Information' section, including your name, department, work phone, and immediate supervisor's name.
  3. Indicate if you are requesting full-time leave, intermittent leave, or a reduced schedule leave by checking the appropriate boxes. Specify the dates for your leave.
  4. If you are requesting an intermittent or reduced schedule leave, select the applicable reason for your request, such as a chronic serious health condition or planned medical treatments.
  5. For non-Fmla leaves, check the type of leave you wish to apply for, if applicable, and detail your preferred start and end dates for the leave.
  6. Read and understand the responsibilities regarding health care coverage and return to work requirements, as outlined in the application.
  7. Sign and date the application to confirm your understanding and agreement with the conditions stated.
  8. Submit your completed application to Human Resources, ensuring to keep a copy for your records. Download, print, or share the form as needed.

Begin your Fmla application online today to secure your leave.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

FMLA: Forms | U.S. Department of Labor
Certification Forms · Employee's serious health condition, form WH-380-E – use when a...
Learn more
Family and Medical Leave Act (FMLA) Request Form
An FMLA leave of absence is a leave without pay. Paid leave (using accrued sick time or...
Learn more
Parental leave - Wikipedia
Parental leave, or family leave, is an employee benefit available in almost all countries...
Learn more

Related links form

Negotiated Govt To Govt - East Avenue Medical Center - Eamc Doh Gov POIR Conference Funding GuidelinesApplication - Dornsife Usc Hepatitis C Enhanced Treatment Plan Form - Maryland Physicians Tenant Manager Billing Form - Cityofanacortes

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

To apply for FMLA, the employee must take an FMLA Medical Certification Form to their health care provider. This form ensures that the employee's or family member's applicable health condition is valid. After receiving the form, the employee must return it within 15 calendar days.

FMLA eligibility requires the following criteria: The employee must have been employed with the company for 12 months. The employee must have worked at least 1,250 hours during the 12 months prior to the start of FMLA leave. The employer is one who employs 50 or more employees within a 75-mile radius of the worksite.

They have designated seven different FMLA application forms aligned to the reason for the qualified leave and how much information your employer requires in order to approve or deny the request. You can download the form from the DOL-WHD website or by calling them at 1-866-487-9243.

Under the FMLA, a serious health condition is an illness, injury, impairment or physical or mental condition that involves inpatient care (defined as an overnight stay in a hospital, hospice or residential medical care facility; any overnight admission to such facilities is an automatic trigger for FMLA eligibility) or ...

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Fmla Application
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232