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Theres nothing for you to fill out yourself, but if your employer uses this form to ask for additional information to determine whether your leave request is valid, youll need to take steps to provide that information.
Because of doctors workloads and the inability in many situations to render a precise prognosis about the frequency and duration of a condition, it can be a challenge when they have to complete patients FMLA request forms.
This form is to be completed by physician or other health care provider and returned to: ☐ the employee, or ☐ the employer (below): Information sought on this form relates only to the condition for which the employee is taking leave.
Your employer must notify you if you are eligible for FMLA leave within five business days of your first leave request. If the employer says that you are not eligible, it has to state at least one reason why you are not eligible (for example, you have not worked for the employer for a total of 12 months).
Eligibility Notice, form WH-381 informs the employee of his or her eligibility for FMLA leave or at least one reason why the employee is not eligible.
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People also ask

Yes. Doctors can and usually do charge a fee to complete Family and Medical Leave Act (FMLA) certifications. Under federal law, employers are not required to pay for fees charged for FMLA certification (other than for a second or third opinion), so the employee must take on that responsibility.
Use Frances Online to apply for benefits. Frances Online is the quickest and easiest way to apply for Paid Leave. You can check your account 24 hours a day, seven days a week. If you cant access Frances Online, send us a paper application or call us at 833-854-0166.
The employer should provide the required notices to the employee seeking leave. Completed certification forms should be given to the employee to provide to the employer, as it is the employees responsibility to provide the employer with the completed certification.

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