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FMLA Medical Certification Forms for Family Members

FMLA Medical Certification Forms for Family Members

DOL-approved form to verify that employee needs time off to care for ill family member

Item Type SKU Qty Price
Packs of 25 EZ-426 $15.95
   
   

FMLA-covered employers have the right to ask an eligible employee requesting FMLA leave to provide a medical certification from a physician as evidence that the employee needs time off to care for a seriously ill family member.

The U.S. Department of Labor FMLA regulations, effective January 16th, 2009, include revisions to the standard DOL medical certification form.

To help employers meet their obligations under the FMLA, and to assist them in obtaining certified opinions from medical doctors, Personnel Concepts has made the revised DOL medical certification form available in packs of 25.

(Note: This version of the form applies to employees; the DOL has a separate form available for certifying an employee's serious health condition. Please see item # EZ-425 for that version of the form.)

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