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Get Southern Utah University Family And Medical Leave Authorization Form - Extended Absence
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How to fill out the Southern Utah University Family And Medical Leave Authorization Form - Extended Absence online
Filling out the Southern Utah University Family And Medical Leave Authorization Form - Extended Absence is an important step for employees seeking leave due to family and medical reasons. This guide provides a clear, step-by-step approach to help you navigate the online form effectively.
Follow the steps to complete your Family And Medical Leave Authorization Form online.
- Click the ‘Get Form’ button to obtain and access the Family And Medical Leave Authorization Form for Extended Absence in your preferred format.
- Begin by entering your personal information in the designated fields. Fill in your name, T-number, department, and hire date accurately.
- In the ‘Type of Leave Requested’ section, select the appropriate box that corresponds to your leave request. This may include options like ‘Employee Family and Medical Leave’ or ‘Leave to care for a newborn’.
- Specify the start date and end date for your requested leave. Ensure that these dates align with your circumstances.
- Provide a brief explanation of the reason for your leave, listing any relevant medical conditions. This information is crucial for processing your request.
- Check the appropriate reason for your leave by selecting one of the provided options, such as your personal health condition, a family member's health condition, or for childbirth.
- Review the ‘Insurance Premium Recovery Authorization Form’ section and provide your printed name, T-number, and signature, along with the date.
- Read through and sign the ‘Insurance Premium Reimbursement Agreement,’ again providing your printed name, T-number, signature, and date.
- If applicable, ensure all healthcare provider certifications are attached per the guidelines listed in the ‘Leave Certification Requirements’ section.
- Finally, save your changes, download the completed form, print a copy for your records, and share it with the appropriate office as instructed.
Complete your Family And Medical Leave Authorization Form online today to ensure your leave is properly processed.
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