U S Department of LaborWage and Hour Division (WHD)FMLA-87 2026

1. Click ‘Get Form’ to open the FMLA-87 in the editor.
2. Begin by filling out your personal information, including your name, preferred email address, position, and work location.
3. Indicate the beginning date of your leave and your expected return date. Even if tentative, these dates are crucial.
4. Select the reason for your request from the provided options, ensuring you check the appropriate box.
5. Sign and date the form at the bottom to certify that all information is accurate.
6. Once completed, save your changes and return the form via email to Human Resources at hcpsfmla@henrico.k12.va.us or fax it to (804) 652-3763.

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