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Men (e.g., prescription drugs, physical therapy requiring special equipment): 7. The relationship of the patient with a serious health condition to the employee is: Reciprocal beneficiary Spouse Parent (including biological parent, foster parent, adoptive parent, parent-in-law, stepparent, legal guardian, biological or adoptive grandparent, or biological or adoptive grandparent-in-law) Child (including a biological, adopted, or foster son or daughter; a stepchild; or a legal ward of the employ.

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Podiatrists, dentists, clinical psychologists, optometrists and chiropractors can all certify leave, as can nurse practitioners, nurse-midwives, clinical social workers and physician assistants. ...

Your employer gives you a form to have your doctor fill out certifying your need for leave under the FMLA. ... Under the FMLA, an employer can request that you have your doctor complete a form certifying your need for leave under the FMLA.

What are the limitations of FMLA? Your employer may ask for documentation of the mental illness. Only a qualified professional (usually a doctor or a therapist) can provide you with the documentation you need.

A complaint may be filed in person, by mail or by telephone with the Wage and Hour Division, U.S. Department of Labor. ... The complaint should be filed within a reasonable time of when the employee discovers that his or her FMLA rights have been violated.

Your employer gives you a form to have your doctor fill out certifying your need for leave under the FMLA. ... The employer must demand this certification in writing, and must provide you with at least 15 calendar days with which to get the form completed by your doctor, and into the hands of the employer.

This form, like 380-E, requires the employer, employee, and the health care practitioner to complete specific information. Your relative's medical provider must complete the rest of the form with information similar to that required by Form 380-E such as: When did the condition begin.

Completing the FMLA Form. Ask your employer to complete Section 1 of the form. Your employer will be required to provide your name, job description, work schedule, and job functions on the FMLA form in Section 1. Fill out Section 2 of the form.

Doctors aren't the only health care providers who may certify FMLA leave. Podiatrists, dentists, clinical psychologists, optometrists and chiropractors can all certify leave, as can nurse practitioners, nurse-midwives, clinical social workers and physician assistants.

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© Copyright 1997-2025
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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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