Transcription of Certification of Health Care Provider for …
{{id}} {{{paragraph}}}
Example: confidence
Certification of Health Care Provider for …
Certification of Health care Provider for Department of Labor employee 's serious Health Condition Wage and Hour Division (Family and Medical Leave Act). DO NOT SEND COMPLETED FORM TO THE DEPARTMENT OF LABOR; RETURN TO THE PATIENT OMB Control Number: 1235-0003. Expires: 5/31/2018. SECTION I: For Completion by the EMPLOYER. INSTRUCTIONS to the EMPLOYER: The Family and Medical Leave Act (FMLA) provides that an employer may require an employee seeking FMLA protections because of a need for leave due to a serious Health condition to submit a medical Certification issued by the employee 's Health care Provider .
Page 1 Form WH-380-E Revised May 2015 Certification of Health Care Provider for U.S. Department of Labor Employee’s Serious Health Condition Wage and Hour Division (Family and Medical Leave Act)
Tags:
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document:
Related search queries
CERTIFICATION BY EMPLOYEE’S HEALTH, Employee, S SERIOUS, S Health, CERTIFICATION OF EMPLOYEE'S SERIOUS HEALTH, HEALTH, Certification of Health Care Provider, S Serious Health, Certification, SERIOUS HEALTH, California, Family, Family Member, Department of Citywide Administrative Services, Department of Citywide Administrative Services CERTIFICATION OF PHYSICIAN, Serious