Get Medical Leave Fact Sheet

This guide is designed to assist faculty and staff members at Illinois State University in filling out the Medical Leave Fact Sheet online. It provides a comprehensive overview of each section and field of the form, ensuring a smooth and efficient submission process.

Follow the steps to complete the Medical Leave Fact Sheet online effectively.

1. Press the ‘Get Form’ button to obtain the Medical Leave Fact Sheet and open it in your editing tool.
2. In Section I, begin by filling out your full name and University ID in the designated fields. This information identifies you as the applicant.
3. Provide your address, home phone number, and city, state, and zip code in the respective fields to ensure accurate contact information.
4. Indicate your work phone number and employee type by selecting either Administrative/Professional, Civil Service, or Faculty, and specify your employment percentage.
5. Enter your department and mail code, along with your supervisor's name for organizational purposes.
6. For the beginning date of your leave, input the exact date you plan to start your leave. Also, estimate the length of your leave and document your last day worked.
7. Outline your normal work schedule, including the days and times you typically work.
8. Choose the type of leave you are requesting by circling the appropriate option: Continuous, Intermittent, Reduced Schedule, or Worker’s Comp.
9. Label the reason for your leave by circling the applicable basic leave or military family leave options and providing the names/details required.
10. Review the terms regarding documentation and your responsibilities during the leave. Initial each statement to confirm understanding.
11. Sign and date the application at the bottom of Section I to certify that all information is accurate and complete.
12. Submit the completed form as directed; ensure that required medical certifications are received within the specified timeframe.

Complete your Medical Leave Fact Sheet online today to ensure a smooth leave process.