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  1. Click ‘Get Form’ to open the WH-382 form in the editor.
  2. Begin by filling out Section I, which requires employer details. Enter the date, employer's name, and employee's name.
  3. In Section I, select the reason for leave from the provided options, ensuring you check all that apply.
  4. Next, indicate whether the FMLA leave request is approved or not. If not approved, specify the reasons in the designated area.
  5. If additional information is needed (Section II), clearly outline what is required from the employee to complete their request.
  6. Finally, in Section III, confirm approval of FMLA leave and provide details on how much leave will be counted against their entitlement.

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382 medical

Designation Notice US Department of Labor under the Family

Form WH-382, Revised June 2020 ・ a fully completed Form WH-382 provides employees with the information required ・ found on the WHD website

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