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Health Care Provider Certification for FMLA Leave PDF Download


Health Care Provider Certification for FMLA Leave PDF Download
 
Health Care Provider Certification for FMLA Leave PDF Download
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The FMLA Certification of Health Care Provider Form is a double sided form requesting information pertaining to the request for leave. This form must be returned within 15 days to the employer. The form gives explanations of "serious health conditions" which may qualify the employee for FMLA. In addition it asks detailed questions regarding the circumstance behind the leave as well as the possible duration. It is necessary to obtain as much information as possible when an employee is out and this form provides documentation should a legal dispute arise. In addition we also provide Employee Request for FMLA and the Response to FMLA Request Forms as a convenient way to document each portion of the leave taken.

Product Specifications:
  • This form is 8.5" x 11"
  • Downloadable PDF
 
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