Get Medical Certification Employees Own Serious Health Condition

Filling out the Medical Certification for an employee's serious health condition is an essential step in requesting leave under the Family and Medical Leave Act. This guide will provide you with clear instructions for completing the form online, ensuring that you provide all necessary information to support your leave request.

Follow the steps to complete your medical certification form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your personal information, including your full name and employer. Include your leave request number and the probable dates for your leave, specifying if it will be continuous, intermittent, or reduced schedule leave.
3. In Step 1 - Patient’s Condition, provide a detailed statement regarding your health condition. Make sure to clearly state how this condition qualifies under the FMLA regulations and affects your ability to perform your job duties.
4. Select the appropriate descriptions of your condition from the options provided. Ensure you check all applicable reasons for your medically necessary absence from work.
5. In Step 2 - Dates of Leave, indicate whether your leave is continuous or intermittent, and provide specific start and end dates. It is important to give estimated schedules for appointments or treatments if applicable.
6. Complete Step 3 by providing your health care provider's information. Ensure they sign and include their practice and credentials, as this section is crucial for verifying your medical need for leave.
7. Once all sections are filled out entirely, review the form to ensure accuracy. You can then save your changes, download the completed form, print it, or share it as required.

Ensure your medical certification is filled out correctly by completing the form online today.