Follow the steps to complete the CA LAUSD/HR 8239 online form.

1. Click ‘Get Form’ button to access the CA LAUSD/HR 8239 form and open it in the editor.
2. Begin filling out the top section of the form. Provide your name as the employee, employee identification number, health insurance provider with member number, work location, and job title as required.
3. Indicate if the health condition claimed is serious under the Family and Medical Leave Act (FMLA) by checking 'yes' or 'no'. Specify if the leave is for yourself or a family member.
4. If the leave is for a family member, provide details about the care you will offer, an estimated duration for the care, and a schedule if the leave will be intermittent or reduced.
5. Read the authorization statement regarding the release of health information carefully. If you agree, sign and date the form. Include the name and relationship of any applicable family member.
6. In the designated sections for the health care provider, ensure they complete the information related to the patient’s health condition. This includes confirming the incapacity, the nature of the condition, treatment details, and any restrictions upon return to work.
7. After both the employee and health care provider have completed their sections, review the form for any errors or omissions.
8. Save changes, download the completed form, print it out, or share it as required. Make sure to submit the original document as instructed, while faxed copies cannot be accepted.

Complete your CA LAUSD/HR 8239 form online today to ensure accurate and timely submission.