Human cgflmatop printable 2025

1. Click ‘Get Form’ to open the human cgflmatop printable in the editor.
2. In Part A, enter the employee’s name, last day worked, classification, work unit, department contact, and their phone number. Ensure you attach a copy of the employee’s job description.
3. For Part B, as the employee, complete your daytime contact phone number and regular work schedule. Be mindful to return this form within 15 calendar days.
4. In Part C, provide your health care provider with the form. They will need to fill out their details and answer specific medical questions regarding your condition.
5. In Part D and E, ensure that your health care provider accurately answers questions about your medical facts and the amount of time needed for leave. This includes any follow-up treatments or modifications required for your job.

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