Family and Medical Leave Request - Austin Peay State University - apsu: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by filling out your personal information in Part I, including your name, employment date, and contact numbers. This ensures that your request is properly attributed to you.
Indicate the purpose of your leave request by selecting the appropriate option: serious illness of yourself or a family member, or for birth/adoption purposes. If applicable, provide details such as the child's name and date of birth.
Designate how you wish to use your leave by selecting from sick leave, annual leave, or leave without pay. Be sure to specify the start and end dates for each type of leave you are requesting.
If you require special leave requests like intermittent leave or a reduced work schedule, indicate 'Yes' or 'No' accordingly.
Review the certification requirements and ensure you understand the implications regarding insurance coverage during your leave period before signing and dating the form.

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What medical conditions qualify for FMLA leave?

TYPES OF SERIOUS HEALTH CONDITIONS. The FMLA defines a serious health condition as an illness, injury, impairment, or physical or mental condition that involves either inpatient care or continuing treatment by a health care provider. Both physical and mental health conditions qualify for FMLA leave.

How do you take family medical leave?

How Do I Request FMLA Leave? To take FMLA leave, you must provide your employer with appropriate notice. If you know in advance that you will need FMLA leave (for example, if you are planning to have surgery or you are pregnant), you must give your employer at least 30 days advance notice.

What is the difference between paid family leave and paid medical leave?

Paid family leave is also known as family caregiver leave or family leave insurance. Paid medical leave is also known as temporary disability insurance (TDI) or short-term disability. Paid family and medical leave together are also referred to as family and medical leave insurance (FMLI).

How long does an employer have to hold a job for someone on medical leave?

California Family Rights Act (CFRA) This law applies to employers in California with five or more workers. Like FMLA, this law requires the employer to hold your job or give you a comparable position when you return to work within 12 weeks.