Home
Forms Library
Fmla forms for employee

Family medical leave act form 2025

fmla forms for employee Preview on Page 1

See details

4.8 out of 5

136 votes

The document is a Notice of Eligibility & Rights and Responsibilities under the Family and Medical Leave Act (FMLA) issued by the U.S. Department of Labor. It outlines the eligibility criteria for employees to take FMLA leave, the reasons for which leave can be taken, and the rights and responsibilities of both employees and employers regarding FMLA leave. The notice includes sections on eligibility determination, additional information needed, leave entitlements, health benefits maintenance during leave, return-to-work requirements, and other related obligations.

Here's how it works

01. Edit your fmla forms for employee 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 how to fill out wh 381 via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out family medical leave act form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the Family Medical Leave Act (FMLA) form in the editor.
Begin by entering the date of the request at the top of the form. This is crucial for tracking your eligibility.
Fill in the employer's name and the employee's name in the designated fields to ensure proper identification.
Select the reason for leave from the provided options, such as birth of a child or serious health condition. Make sure to check all that apply.
In Section I, indicate whether you are eligible for FMLA leave by checking the appropriate box. If not eligible, specify why.
If additional information is needed, complete Section II by selecting any required documentation or certifications.
Review Section III carefully to understand your rights and responsibilities under FMLA, ensuring you are aware of your entitlements.

Start using our platform today to easily fill out your FMLA form online for free!

See more family medical leave act form versions

We've got more versions of the family medical leave act form form. Select the right family medical leave act form version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (136 Votes)
2013	4.4 Satisfied (546 Votes)
2009	3.9 Satisfied (34 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.

What is an example of a FMLA letter?

Please be advised that I hereby request an FMLA leave for a period of (number of weeks) in connection with my serious health condition. The leave is to start on (date). Attached is my medical note reflecting the need for FMLA leave. Please let me know whether you approve this leave at your earliest convenience.

Does a doctor have to fill out FMLA paperwork?

The FMLA does not require the use of any specific certification form. The Department has developed optional forms that can be used for leave for an employees own serious health condition (WH-380-E) or to care for a family members serious health condition (WH-380-F).

What is the FMLA family medical leave act?

The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.

How to use the family medical leave act?

Step 1: You must notify your employer when you know you need leave. Step 2: Your employer must notify you whether you are eligible for FMLA leave within five business days. If their notification indicates that you are not eligible, then your leave is not FMLA-protected. (You may request leave again in the future.

What are the rules around FMLA?

ABOUT THE FMLA Eligible employees: Employees are eligible if they work for a covered employer for at least 12 months, have at least 1,250 hours of service with the employer during the 12 months before their FMLA leave starts, and work at a location where the employer has at least 50 employees within 75 miles.