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Get CT CTHR P33A 2006-2024

E submitted within 30 days of foreseeable leave, if leave is FMLA qualifying. Form #: P33A - Employee Revision Date: 4/2006 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 of the person and the address of the agency .

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