Family and Medical Leave Act Request Form

Family and Medical Leave Act Request Form is a 2-page legal document that was released by the U.S. Department of Labor on November 1, 2012 and used nation-wide.

FAQ

Q: What is the Family and Medical Leave Act (FMLA)?
A: The FMLA is a federal law that allows eligible employees to take unpaid leave for certain family and medical reasons.

Q: Who is eligible for FMLA leave?
A: Employees who have worked for a covered employer for at least 12 months and have worked at least 1,250 hours in the past 12 months.

Q: What are some reasons for taking FMLA leave?
A: Some reasons include the birth or adoption of a child, caring for a seriously illfamily member, or the employee's own serious health condition.

Q: How much leave can an employee take under FMLA?
A: An eligible employee can take up to 12 weeks of unpaid leave within a 12-month period, with a few exceptions.

Q: What protections does FMLA provide?
A: FMLA provides job protection, continuation of health insurance coverage, and the right to return to the same or an equivalent position after the leave.

Q: What is the FMLA Request Form used for?
A: The FMLA Request Form is used by employees to formally request FMLA leave from their employer.

Q: What information is required on the FMLA Request Form?
A: The form typically requires information such as the employee's name, reason for leave, dates of leave, and supporting documentation if applicable.

Q: Is FMLA leave paid?
A: FMLA leave is generally unpaid, but employees can choose to use any accrued paid leave (such as vacation or sick leave) during their FMLA leave period.

Q: Can employers deny FMLA requests?
A: Employers can deny FMLA requests if the employee does not meet the eligibility requirements or fails to provide the required documentation.