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Employment or Work Application - General

Employee Request Form For Fmla Leave In San Bernardino

Category:

Employment - Applications

State:

Multi-State

County:

San Bernardino

Control #:

US-00413

Format:

Instant download

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Description

This form is an Employment Application. The form provides that applications are considered without regard to race, color, religion, or veteran status.

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The Family Medical Leave Act allows you to take up to 12 weeks (26 weeks in some cases) of unpaid, job-protected leave. The Leave Request Form and FMLA Certification of Health Care Provider forms are also located on the HR website under Forms and Leave.Calling 1-877-238-4373 to request a paper form be mailed to you. California Relay Service (711) – Provide the PFL number (1-877-238-4373). For leaves due to your own or a Family Member's Serious Health Condition, a Medical Certification form is required. Please contact HR to obtain the form. This is a sample form for employees to request time off under the Family and Medical Leave Act. Do I need my clinician to fill out a form? Log in to your SDI account and select "File a New Claim. " Select "Paid Family Leave Care" and follow the steps to fill out the form.

Employee Request Form For Fmla Leave In San Bernardino

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