Get Request For Family And Medical Leave - Utexas

Completing the REQUEST FOR FAMILY AND MEDICAL LEAVE form at the University of Texas can be a straightforward process. This guide will walk you through each section of the form, ensuring you understand what information is required and how to fill it out properly.

Follow the steps to complete the family and medical leave request form.

1. Press the ‘Get Form’ button to access the REQUEST FOR FAMILY AND MEDICAL LEAVE form and open it in your selected editing tool.
2. Fill in your personal details in the designated fields, including your employee name, UT EID, home address, city, state, zip code, home phone, department contact, other phone, and office phone.
3. Indicate the reason for your leave by selecting the appropriate checkbox corresponding to the circumstances listed. This includes options such as birth and care of your child, adoption, serious health condition, or military caregiver leave.
4. If claiming a serious health condition, provide the age of your child if applicable, along with the relationship to the person requiring care.
5. Check whether your spouse is currently employed by UT Austin, as this may affect your leave allotment.
6. Sign and date the form to affirm that the information provided is accurate and complete.
7. If applicable, have the patient fill out the section related to their consent for releasing the Certification of Health Care Provider form, including their name, signature, and date.
8. Review all entered information for accuracy before finalizing. Save any changes, download the form, and/or print it for submission.

Complete your REQUEST FOR FAMILY AND MEDICAL LEAVE form online today to ensure timely processing of your request.