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Get Form GBRIG-1 Certification Of Health Care Provider For Employee S Serious Health Condition (Family

OMB Control Number: 1235-0003 Expires: 2/28/2015 SECTION I: For Completion by the EMPLOYER INSTRUCTIONS to the EMPLOYER: The Family and Medical Leave Act (FMLA) provides that an employer may require an employee seeking FMLA protections because of a need for leave due to a serious health condition to submit a medical certi.

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