Fmla form 2e 2025

See details

4.3 out of 5

39 votes

The document is a Medical Certification form for employees requesting leave under the Family and Medical Leave Act (FMLA). It includes sections for the employee to provide personal information and authorize their healthcare provider to share necessary medical details. The employer must confirm if a fitness for duty form is required upon the employee's return. The healthcare provider is tasked with detailing the employee's medical condition, treatment needs, and the amount of leave required. Additionally, it emphasizes compliance with the Genetic Information Nondiscrimination Act (GINA) regarding genetic information.

Here's how it works

01. Edit your printable fmla forms online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send fmla indiana via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out FMLA Form 2E with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open FMLA Form 2E in the editor.
In Section 1, enter your name and contact information. Specify your regular work hours and days of the week. Choose whether to authorize your health care provider to share information regarding your leave.
Sign and date the form at the bottom of Section 1, acknowledging that fraudulent claims may lead to disciplinary action.
Section 2 is for your employer. Ensure they complete any required information regarding job functions and return-to-work requirements.
In Section 3, provide the form to your health care provider. They will need to fill out medical facts about your condition, including treatment dates and necessary leave duration.
Once completed, save the document and share it directly from our platform for easy submission.

Start using our platform today for free to streamline your FMLA Form 2E completion!

See more fmla form 2e versions

We've got more versions of the fmla form 2e form. Select the right fmla form 2e version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (49 Votes)
2011	4.3 Satisfied (39 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I fill out my own FMLA paperwork?

The Department of Labor (DOL) has optional certification forms, but your employer may have its own paperwork for certification or to document your leave. Some forms only need to be filled out by your employer or healthcare provider, but others ask you to provide basic details about your situation.

Why do doctors not fill out FMLA paperwork?

A doctor may refuse to complete FMLA paperwork if you are not their patient or lack sufficient medical information. In such cases, you can seek certification from another qualified healthcare provider who is familiar with your fathers condition. Employers must accept valid certifications from appropriate providers.

What paperwork does a doctor need to fill out for FMLA?

FMLA Form WH-380-F for Family Health Condition Provide information about the family member and your relation to them to help confirm your eligibility for leave. This form has the same three sections as the above WH-380-E and will ask you to confirm the amount of leave you require.

Are there different types of FMLA forms?

There are five DOL optional-use FMLA certification forms. Employees serious health condition, form WH-380-E - Use when a leave request is due to the medical condition of the employee.

Try more PDF tools