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The CFRA certification shall be sufficient if it includes all of the following: The date on which the serious health condition commenced. The probable duration of the condition. A statement that, due to the serious health condition, the employee is unable to perform the function of his or her position.
Provide this form if youre an employer covered by the federal Family and Medical Leave Act (FMLA) or the California Family Rights Act (CFRA) and either an employee has requested a leave of absence or you recognize the need.
Under FMLA (Family Medical Leave Act) and CFRA (California Family Rights Act), the employer may require an employee to submit a certification by the employees health care provider to confirm the existence of the medical condition, qualifying for FMLA or CFRA medical leave.
WH-380-E Employees Serious Health Condition For when a leave request is due to the medical condition of the employee. WH-380-F Family Members Serious Health Condition For when a leave request is due to the medical condition of the employees family member.