Get Family Medical Leave Of Absence Request Form - Uab

Filling out the Family Medical Leave of Absence Request Form is an important step for individuals seeking to take leave under the Family and Medical Leave Act (FMLA). This guide provides clear instructions to help you complete the form accurately and efficiently online.

Follow the steps to complete your leave request form correctly.

1. Click ‘Get Form’ button to access the Family Medical Leave of Absence Request Form and open it for completion.
2. Begin by providing your full name, employee number, department, office phone number, home number, and email address in the designated fields.
3. Enter the requested leave start date and end date in the appropriate sections using the format provided.
4. Indicate whether you are requesting continuous/block leave or intermittent leave by checking the corresponding box.
5. Select the reason for your leave of absence from the options provided. If applicable, attach the necessary certification or documentation as specified in the form.
6. Review the acknowledgment section where you affirm your understanding of using accrued benefit time during your leave and the implications of not returning to work.
7. Sign and date the form to indicate your consent and understanding of the leave policies.
8. If applicable, have your department supervisor complete their section and provide their contact information.
9. Once all fields are completed, save your changes. You may then download, print, or share the completed form as needed.

Take the next step in managing your time off by completing the Family Medical Leave of Absence Request Form online today.