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Wh v 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin with Section I, where the employee and/or veteran must provide their information. Fill in the employer's name and address, followed by the employee's name and the veteran's name.
- Indicate the relationship of the employee to the veteran by selecting from options such as Spouse, Parent, Son, Daughter, or Next of Kin.
- In Part B, provide details about the veteran including discharge date and military branch. Answer whether the veteran is receiving medical treatment for an injury or illness.
- Describe in Part C the care needed for the veteran and estimate how much leave will be required.
- Once Section I is complete, ensure a health care provider fills out Section II. This includes confirming medical status and need for care.
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