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Family Medical Leave and/or Dependent Care Leave Request Form CONNECTICUT ONLY Date Supervisor s Name From Department Employee s Name Employee Badge/ID Number I hereby request Paid Dependent Care Leave of Absence for days from through. days from through. Reason for leave Check One FMLA Personal serious illness NA Complete Certification of Health Care Provider WH-380-E Serious illness of your Child Spouse Parent Health Care Provider WH-380-F Military Service member Qualifying Exigencies for Mili ...

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What are the rules around FMLA?

In order to be eligible to take leave under the FMLA, an employee must (1) work for a covered employer, (2) work 1,250 hours during the 12 months prior to the start of leave, (3) work at a location where 50 or more employees work at that location or within 75 miles of it, and (4) have worked for the employer for 12 Qualifying Reasons for FMLA Leave - U.S. Department of Labor dol.gov whd fmla final-rule faq dol.gov whd fmla final-rule faq

How long is family caregiver leave Ontario?

Family caregiver leave is unpaid, job-protected leave of up to eight weeks per calendar year per specified family member.

How does FMLA work for federal employees?

What is the FMLA for federal employees?

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave. Family and Medical Leave (FMLA) | U.S. Department of Labor dol.gov general topic benefits-leave dol.gov general topic benefits-leave

What is the longest you can take FMLA?

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year.

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