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- Click ‘Get Form’ to open Form GBRIG-5 in the editor.
- In Section I, provide your employer's name and address, along with your name and the veteran's name. Indicate your relationship to the veteran by checking the appropriate box.
- Complete Part B by entering the veteran’s discharge date and answering whether they were dishonorably discharged. Provide details about their military branch, rank, and unit.
- In Part C, describe the care you will provide to the veteran and estimate how much leave you will need for this care.
- Once Section I is complete, ensure that a qualified health care provider fills out Section II. This includes providing their information and confirming the veteran's medical status.
- Review all sections for accuracy before saving or printing the completed form. Remember not to send it to the Department of Labor; return it directly to your employer.
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