Family and Medical Leave Forms
for
Your State
Specifically designed to be used to comply with the Federal Family and Medical Leave Act.
This form is to be used to comply with the Federal Family and Medical Leave Act which requires that eligible employees be entitled to up to 12 weeks of unpaid and job-protected leave for certain family and medical reasons.
This form is for use in all states.
Among others, this form includes the following provisions:
Eligibility
Reasons for requested leave
This form is for use in all states.
Among others, this form includes the following provisions:
Eligibility
Reasons for requested leave
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
Number of Pages3
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#22089
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.