Get Cuny Fmla Form-3 B 2015-2025

Filling out the CUNY FMLA Form-3 B is an essential step for any user looking to provide care for a family member with a serious health condition. This guide offers clear, step-by-step instructions to help you complete the form efficiently and accurately.

Follow the steps to fill out the CUNY FMLA Form-3 B online.

1. Click the ‘Get Form’ button to access the form and open it in the appropriate editor.
2. In Section I, enter the college name, which is La Guardia Community College, along with the city (Long Island City), state (NY), address (31-10 Thomson Ave, E-407), and zip code (11101). Provide the name of the employee who is requesting leave and the employee's ID number. Include their contact number and fax number.
3. In Section II, begin by filling in the name of the family member for whom care will be provided. Describe the nature of care you will provide, including any specific medical assistance, daily activities, or other forms of support expected.
4. Estimate the amount of leave needed for providing care. Be specific about the duration and frequency of leave required.
5. In Section III, provide details required by the health care provider. The health care provider should accurately answer questions pertaining to the patient's health condition, diagnosis, and any necessary treatment plans while ensuring clarity and specificity in their responses.
6. Under Part A, the health care provider will indicate the approximate date the condition commenced, its probable duration, and whether the patient needs continuous treatment.
7. In Part B, the provider needs to specify the amount of care required, including whether the patient will be incapacitated for a continuous period and any follow-up treatment needed.
8. Upon completion, ensure the health care provider signs the form and provides their licensing information, along with the date.
9. Finally, save the changes to your completed form. You may also choose to download, print, or share the document as needed.

Take action today and complete the CUNY FMLA Form-3 B online for a seamless experience.