FMLA Usage Tracker Form

According to the Family and Medical Leave Act (FMLA), covered employees should be eligible to take a total of 12 weeks off of work per year for a covered condition, such as an illness, childbirth, or to tend to the needs of a qualifying family member. As of January 16, 2009, employees may also be able to take military family leave. However, these FMLA leave days do not have to be taken consecutively and can be difficult for employers to accurately manage and track.

Our FMLA Usage Tracking form allows employers to record, track, and document the days that employees leave work under qualifying FMLA conditions. Using this form, employers will be able to ensure that they are compliant with their documentation of employee FMLA days and that employees take an excusable amount of time away from work for qualifying conditions.

Our form is easy to read and fill in, giving employers an at-a-glance analysis of days off and alerting them to possible FMLA abuse patterns. It is also available in Spanish and English to help employers meet possible state bilingual regulations.

Employers may also purchase the FMLA Usage Tracking form as part of the FMLA Administrator kit, which includes the FMLA Employer Guide, FMLA Administrator Worksheet, FMLA Employee Request for Leave Form, FMLA Employer Response for Leave Form, and more.