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.
A FMLA General Notice Employee Rights and Responsibilities under The Fam.pdf 193.84 KB (Last Modified on April 11, 2023) -
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.
C Medical Certification Employees Family Members Serious Health Condit.pdf 205.13 KB (Last Modified on April 11, 2023) -
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.
D Medical Certification Employees Serious Health Condition D2016.pdf 256.86 KB (Last Modified on April 11, 2023) -
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.