This form is an Employment Application. The form provides that applications are considered without regard to race, color, religion, or veteran status.
Employee Request Form For Fmla Leave In Montgomery
Category:
State:
Multi-State
County:
Montgomery
Control #:
US-00413
Format:
Word;
Rich Text
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Employees can submit FMLA leave requests, check the status of pending requests, submit medical certifications and other applicable paperwork online. Date: Supervisor Name.INSTRUCTIONS: Please complete form, discuss leave plans with immediate supervisor, obtain signatures, attach proper documentation,. Within the last 7 years, have you worked at least a total of 12 months at MC? Employee's serious health condition, form WH-380-E – use when a leave request is due to the medical condition of the employee. Employees will be provided an FMLA leave application form and a medical certification form. FMLA provides certain employees with up to twelve (12) weeks of unpaid FMLA leave in a twelve (12) month period.