FMLA Request

The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.
Eligible employees are entitled to:

Twelve workweeks of leave in a 12-month period for:

• the birth of a child and to care for the newborn child within one year of birth;
• the placement with the employee of a child for adoption or foster care and to care for the newly placed child
  within one year of placement;to care for the employee’s spouse, child, or parent who has a serious health condition;
• a serious health condition that makes the employee unable to perform the essential functions of his or her
  job;
• any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a
  covered military member on “covered active duty

Click here to complete your request.