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CERTIFICATION OF EMPLOYEE'S SERIOUS HEALTH ... - APWU

www.apwu.org

APWU Form 1 (Rev. Feb. 2016) Page 1 CERTIFICATION OF EMPLOYEE'S SERIOUS HEALTH CONDITION FOR FAMILY AND MEDICAL LEAVE This form must be completed by a Health Care Provider when FMLA leave is requested and

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CERTIFICATION OF FAMILY MEMBER’S SERIOUS HEALTH ... - …

www.apwu.org

APWU Form 2 (Rev. Feb. 2016) Page 1 CERTIFICATION OF FAMILY MEMBER’S SERIOUS HEALTH CONDITION FOR FAMILY AND MEDICAL LEAVE This form must be completed by a health care provider when FMLA leave is requested and

  Form, Family, Members, Certifications, Apwu, Certification of family member s, Apwu form

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