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Click ‘Get Form’ to open the WH 380 F in the editor.
In Section I, enter the employer's name and contact information. This section is crucial as it verifies the employer's involvement in the FMLA process.
Move to Section II, where you will fill in your personal details such as your name and relationship to the family member needing care. Be sure to describe the care you will provide and estimate how much leave you will need.
Proceed to Section III for completion by the health care provider. Ensure they provide detailed medical facts about the condition, including treatment schedules and any necessary follow-up care.
Review all sections for completeness and accuracy before saving or sharing the document. Utilize our platform’s features to sign electronically if required.
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What is the difference between WH 380 E and 380 F?
Employees serious health condition, form WH-380-E - Use when a leave request is due to the medical condition of the employee. Family members serious health condition, form WH-380-F - Use when a leave request is due to the medical condition of the employees family member.
What is form WH 380?
So long as the document is signed by a health care provider, and is complete and sufficient in the sense that it provides the employer with all of the information needed to determine if the leave is covered by the FMLA, then the certification should be accepted.
How to complete form WH-380-F?
Certification of Health Care Provider for Employees Serious Health Condition under the Family and Medical Leave Act - WH-380-
wh 380 f
Wh 380 f pdfwh-380-ewh-381wh-380-f fillable formWH 380 FMLAfmla form (pdf)FMLA formswh-382
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Certification of Health Care Provider for Family Members
Form WH-380-F, Revised June 2020. Page 1 of 4. Certification of Health Care Provider for. Family RETURN TO THE PATIENT. Form WH-380-F, Revised June 2020.
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