Get the up-to-date form 9611-2025 now

Show details

4.8 out of 5

251 votes

The document is an application form for leave under the Family and Medical Leave Act (FMLA), requiring personal information, the purpose of leave, anticipated dates, and hours of leave needed. It includes options for various types of leave related to family or personal health conditions and requires medical certification if applicable. The form also indicates approval or denial of the leave request.

Here's how it works

01. Edit your form 9611 online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send form 9611 fmla via email, link, or fax. You can also download it, export it or print it out.

The best way to edit Form 9611 in PDF format online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Handling paperwork with our extensive and user-friendly PDF editor is easy. Follow the instructions below to complete Form 9611 online quickly and easily:

Sign in to your account. Log in with your credentials or create a free account to test the product prior to choosing the subscription.
Import a document. Drag and drop the file from your device or add it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
Edit Form 9611. Effortlessly add and highlight text, insert images, checkmarks, and icons, drop new fillable fields, and rearrange or remove pages from your document.
Get the Form 9611 completed. Download your modified document, export it to the cloud, print it from the editor, or share it with others using a Shareable link or as an email attachment.

Take advantage of DocHub, one of the most easy-to-use editors to promptly handle your documentation online!

See more form 9611 versions

We've got more versions of the form 9611 form. Select the right form 9611 version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2014	4.1 Satisfied (40 Votes)
1997	4.8 Satisfied (251 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Why are doctors hesitant to fill out FMLA paperwork?

Because of doctors workloads and the inability in many situations to render a precise prognosis about the frequency and duration of a condition, it can be a challenge when they have to complete patients FMLA request forms.

What are the federal FMLA eligibility requirements?

Employees are eligible for leave if they have worked for their employer at least 12 months, at least 1,250 hours over the past 12 months, and work at a location where the company employs 50 or more employees within 75 miles.

What does HR do with FMLA paperwork?

Some FMLA forms do not require you to fill out the form yourselfthey require you to take specific steps to prove your need for taking leave or provide information about how long youll miss work. Usually, an employer or doctor fills out most of the forms.

What is the role of HR in the FMLA program?

HR responsibilities Review the employees records to determine his or her FMLA eligibility. If the employee is ineligible, draft the necessary denial letter and notify the employee.

What happens if FMLA paperwork is not returned?

If an employee fails to return the certification in a timely manner, the employer can deny FMLA protections for the leave following the expiration of the 15-calendar day period until a complete and sufficient certification is provided.

form 9611 irs

Form 9611 instructions FMLA forms Irs form 9611 Form 9611 pdf fmla form (pdf) Printable FMLA forms for family member FMLA medical certification form Printable FMLA medical certification form

Related forms

be ready to get more

Complete this form in 5 minutes or less

Get form

Who has access to FMLA paperwork?

The employees supervisor or manager can have access to limited information about the employees medical condition and work restrictions. Government officials can access FMLA records in order to perform an audit and ensure conformance with federal and state laws.

How do employers verify FMLA paperwork?

ing to the U.S. Department of Labors FMLA Guide for Employers, Authentication means providing the health care provider with a copy of the certification and confirming that the information contained on the certification form was completed and/or authorized by the health care provider who signed the document.

Get the up-to-date form 9611-2025 now

Here's how it works

The best way to edit Form 9611 in PDF format online

See more form 9611 versions

Complete this form in 5 minutes or less

Got questions?

Why are doctors hesitant to fill out FMLA paperwork?

What are the federal FMLA eligibility requirements?

What does HR do with FMLA paperwork?

What is the role of HR in the FMLA program?

What happens if FMLA paperwork is not returned?

Complete this form in 5 minutes or less

People also ask

Who has access to FMLA paperwork?

How do employers verify FMLA paperwork?

fmla spouse

Try more PDF tools