Path Home About State Agency Divisions Human Resources Family and Medical Leave Application Serious Injury or Illness of Covered Service Member for Military Family Leave
Jump to navigation

Serious Injury or Illness of Covered Service Member for Military Family Leave

Please complete the following form and submit with the FMLA Request Form to Human Resources:

Certification Form WH-385

FMLA Personnel Policy

Family and Medical Leave Act (FMLA) Request Form

Please submit the completed FMLA Request Form and supporting documentation for eligible circumstance to Human Resources for verification and approval.

 

 

Jump to content