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  • Or Pd 615a 2013

Get Or Pd 615a 2013-2025

E s Name: Patient s Name: (Please check one) Relationship to patient: self spouse parent child (age ) domestic partner parent-in-law grandparent grandchild parent of domestic partner child of a domestic partner (age ) Section II: Health Care Provider Completes this Section Please complete all sections in order for the agency to.

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All Oregon workers get sick time, but those who work for larger employers can qualify for protected leave under OFLA or the federal Family and Medical Leave Act (FMLA). OFLA leave gives you job protection, but OFLA is unpaid unless you have vacation, sick, or other paid leave.

Complete application for FMLA/OFLA Leave. 2. Have your medical provider complete the Medical Certification Form if required. The certification can be faxed directly to HR (541) 325-0435 from the medical provider's office, or the employee may provide it directly to HR.

Employee must have worked for at least 1250 hours during the 12-month period immediately preceding the leave. condition requiring home care), in addition to the 180-day requirement above, the employee must have worked an average of 25 hours per week. Both of the above requirements apply to all types of FMLA leave.

Telephone: (877)499-8606. Fax: (888)485-0973.

If you have questions, or you think that your rights under the FMLA may have been violated, you can contact WHD at 1-866-487-9243. You will be directed to the WHD office nearest you for assistance.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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