No information is available for this page. (1) Employees requesting FMLA leave must initially contact AbsencePRO at 877-365-2666 and file their initial claim for FMLA.This is a sample form for employees to request time off under the Family and Medical Leave Act. For agency use only. Additionally, they may take up to 26 weeks of FMLA leave in a single 12-month period to care for a covered service member with a serious injury or illness. Employee FMLA Checklist. The FMLA process can be complex. Additionally, you may take up to 26 weeks of FMLA leave in a single 12-month period to care for a covered servicemember with a serious injury or illness. I have a need for leave for a reason that may qualify under the FMLA. •. Complete Return to Work Form.
