Human Resources
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Forms
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FMLA General Notice for Employees Rights and Responsibilities under FMLA
Informational notice providing general guidelines for employees' rights and responsibilities under the Family Medical Leave Acts, FMLA.
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Medical Certification for Family Members Serious Health Condition
This Medical Certification is completed by the employee's family members' medical provider when needing to take time off for family sick leave.
Medical Certification for Family Members Serious Health Condition.pdf 197.4 KB (Last Modified on July 14, 2022) -
Medical Certification for Employee's Own Serious Health Condition
This Medical Certification is completed by the employee's medical provider when he/she needs to be off work for their own medical condition.
Medical Certification for Employees Serious Health Condition.pdf 385.37 KB (Last Modified on July 14, 2022) -
Pregnancy Disability Leave Form
The Pregnancy Disability Leave Form is to be completed by the medical provider for an employee requesting leave from work due to pregnancy related matters/care.
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Declaration of Relationship Form
The Declaration of Relationship Form is to be used when requesting time off work for family members' medical condition or parental leave.
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Leave of Absence Request Form
The Leave of Absence Request Form is to be used when a Management, Certificated, or Classified employee is requesting medical or non-medical leave.