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How to use or fill out Form I - Non FMLA Certification - Family Members Health Condition
- Click ‘Get Form’ to open it in the editor.
- In Section II, enter your name and the name of the family member you will care for. Specify your relationship and, if applicable, their date of birth.
- Describe the care you will provide and estimate the leave needed. Be detailed to ensure clarity.
- Sign and date the form at the bottom of Section II before passing it to your family member's health care provider.
- In Section III, ensure that the health care provider fills out all relevant medical information, including treatment dates and necessary care details.
- Review all sections for completeness before submitting. Make sure all signatures are present.
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| Versions | Form popularity | Fillable & printable |
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| 2024 | 4.7 Satisfied (24 Votes) | |
| 2023 | 4.3 Satisfied (27 Votes) | |
| 2023 | 4.1 Satisfied (45 Votes) | |
| 2023 | 4.1 Satisfied (46 Votes) | |
| 2023 | 4.4 Satisfied (35 Votes) | |
| 2022 | 4.8 Satisfied (52 Votes) | |
| 2022 | 4.6 Satisfied (28 Votes) | |
| 2021 | 4.8 Satisfied (61 Votes) | |
| 2021 | 4.8 Satisfied (31 Votes) | |
| 2021 | 4.7 Satisfied (124 Votes) | |
| 2021 | 4.8 Satisfied (145 Votes) | |
| 2021 | 4.8 Satisfied (89 Votes) | |
| 2021 | 4.8 Satisfied (49 Votes) | |
| 2021 | 4.5 Satisfied (36 Votes) | |
| 2021 | 4.2 Satisfied (40 Votes) |
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