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Request for Leave or Approved Absence
Certification: I hereby request leave/approved absence from duty as indicated above and docHub that such leave/absence is requested for the purpose(s)
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FMLA Sample APWU Form for Employee Long Term
FOR FAMILY AND MEDICAL LEAVE. This form must be completed by a Health Care Provider when FMLA leave is requested and medical documentation is required
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WH-381 (.pdf)
You have a right under the FMLA to take unpaid, job-protected FMLA leave in a 12-month period for certain family and medical reasons, including up to 12 weeks
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