Intermittent fmla paperwork fmla forms
[DOC File]REQUEST FOR LEAVE OF ABSENCE
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Part B. Leave Dates (Continuous or Intermittent) Estimated Leave Start Date: Estimated Date of Return: Leave is requested on an intermittent or reduced leave schedule. Indicate the days of the week and/or hours during the day you will be absent: Anticipate using short or long term disability benefit during leave. Part C. Reason for Leave
[DOT File]FMLA Response Form
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Intermittent Absence (working some days and absent some days. Why must leave be taken intermittently? List dates and time for which you are requesting leave? List dates and time of scheduled medical appointments related to the serious health condition: ... FMLA Response Form ...
[DOCX File]FMLA Notification Letter
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Upon the conclusion of the intermittent time off from an FMLA qualifying absence, you will be placed in the same position you had before the absence started or an equivalent position. If you return to work after you have exhausted your FMLA leave benefit, you will be placed according to University of Michigan policy and practice.
[DOCX File]Family and Medical Leave Act – Employee Request
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All requests for FMLA must be submitted as promptly as possible after you become aware of a need for leave. Failure to notify your employer in a timely manner according to agency procedures may result in a delay in the processing of your FMLA. You must continue to follow your work unit’s existing attendance policy and call-in procedures.
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