Certification of Health Serious Health Condition (Family and Medical Leave Act) is a legal document that was released by the Delaware Department of Human Resources - a government authority operating within Delaware.
Q: What is the Certification of Health Care Provider for Family Member's Serious Health Condition?
A: It is a form required by the Family and Medical Leave Act (FMLA) in Delaware to certify the serious health condition of a family member for whom an employee is requesting leave.
Q: Who needs to complete the Certification of Health Care Provider form?
A: The form needs to be completed by the health care provider of the family member who has a serious health condition.
Q: What does the Certification of Health Care Provider form ask for?
A: The form asks for information about the family member's medical condition, the expected duration of the condition, and the treatment being received.
Q: Do I need to submit the Certification of Health Care Provider form to my employer?
A: Yes, you need to submit the completed form to your employer to support your request for Family and Medical Leave Act (FMLA) leave.
Q: Can my employer contact the health care provider to verify the information on the Certification of Health Care Provider form?
A: Yes, your employer has the right to contact the health care provider to authenticate the information provided on the form.
Q: Is the information on the Certification of Health Care Provider form confidential?
A: Yes, the information on the form is confidential and should be kept separate from an employee's personnel file.
Q: What happens if I fail to provide a completed Certification of Health Care Provider form?
A: If you fail to provide a completed form, your employer may deny your request for Family and Medical Leave Act (FMLA) leave.
Q: Can I be required to provide additional medical documentation besides the Certification of Health Care Provider form?
A: Yes, in some cases, your employer may request additional medical documentation to verify the need for FMLA leave.
Form Details:
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Delaware Department of Human Resources.