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BARROW COUNTY SCHOOLS REQUEST FOR FAMILY AND MEDICAL LEAVE according to BOE Policy GBRIG CERTIFICATION/DOCUMENTATION (Please Print) Social Security Number Date Last Name First Initial State Zip Code.

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Employees must make reasonable efforts to schedule leave for planned medical treatment so as not to unduly disrupt the employer's operations. Leave due to qualifying exigencies may also be taken on an intermittent basis. Employees may choose or employers may require use of accrued paid leave while taking FMLA leave.

To apply for FMLA, the employee must take an FMLA Medical Certification Form to their health care provider. This form ensures that the employee's or family member's applicable health condition is valid. After receiving the form, the employee must return it within 15 calendar days.

FMLA may be unpaid leave unless the employee has accrued sick leave and/or vacation hours and/or compensatory hours which he/she is eligible to use for the purpose of the leave. Employee are required to use all their accrued and available leave during an FMLA leave.

The Family and Medical Leave Act (FMLA) allows an eligible state employee to take up to twelve workweeks of leave per rolling twelve-month period for the following qualifying events: Incapacity due to pregnancy, prenatal medical care or child birth; Caring for the employee's child after birth, or placement for adoption ...

Intermittent leave can be utilized when an employee needs to take leave in separate blocks of time due to a single FMLA-qualifying reason. This type of leave can be taken in periods of time ranging from one hour or more to weeks at a time. The total leave used in a 12-month period cannot exceed 12 total weeks.

Employee eligibility Eligible for up to 12 weeks of family leave if the employee has completed 12 months of service. Must also have worked or been on paid leave at least 1250 hours in the 12 months leading up to the first day of family and medical leave.

Please be advised that I hereby request an FMLA leave for a period of (number of weeks) in connection with my serious health condition. The leave is to start on (date). Attached is my medical note reflecting the need for FMLA leave. Please let me know whether you approve this leave at your earliest convenience.

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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