APPENDIX G--Certification of Health Care Provider for Employee’s Serious Health Condition

FMLA (Family Medical Leave Act) forms can be downloaded from the School Personnel Services/Human Resources sub webpage "Forms and Documents".  FMLA forms can also be found on the Department of Labor's website http://www.dol.gov/whd/forms/WH-380-E.pdf.
 
 
The form below is provided as an example only.
 
 

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