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Family and Medical Leave Application

FMLA Personnel Policy - Read prior to completing the FMLA forms.

FMLA Process:

The FMLA process requires the eligible employee to complete the Family and Medical Leave Act (FMLA) Request Form and supporting documentation for eligible circumstance.

Click on appropriate eligible circumstance and complete the corresponding paperwork:

  • Birth or Placement of Child
  • Employee Serious Health Condition
  • Family Member Serious Health Condition
  • Serious Injury or Illness of Covered Service Member for Military Family Leave
  • Qualifying Exigency for Military Family Leave
  • Please submit the completed FMLA Request Form and supporting documentation to Human Resources for verification and approval.

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