APPENDIX H--Certification of Health Care Provider for Family Member’s Serious Health Condition

Family Medical Leave Act (FMLA) forms can be obtained on the School Personnel Services/Human Resources website under Forms and Documents. They also can be downloaded from the U.S. Department of Labor website (http://www.dol.gov/whd/forms/WH-380-F.pdf).
The form below is provided as an example only.
 
 
 
 
 
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