Requesting FMLA Leave. INSTRUCTIONS FOR THE EMPLOYEE: • Complete your part of the form and submit it to HR. • You will be notified as to whether the leave is approved or not.Inability to Return From Leave. An employee who exhausts his or her FMLA leave entitlement may request an additional unpaid leave of absence. An employee should use this form to request FMLA leave involving intermittent periods of time off or a reduced daily or weekly work schedule. How Do You Sign Up for FMLA? The employee will be notified of the determination within 5 days. If you need to request FMLA, please complete the Leave Request Form (PDF) and forward to HR 30 days prior to your expected leave. The Family and Medical Leave Act (FMLA) offers eligible employees up to 12 weeks of unpaid leave in a rolling 12-month period for a personal health condition. PBS Payroll Department.
