Connecticut medical certificate 2025

1. Click ‘Get Form’ to open the Connecticut Medical Certificate in the editor.
2. Begin by filling in the agency name and address at the top of the form. This ensures that your certificate is directed to the correct department.
3. Enter your name, employee number, position, and address in the designated fields. Accurate information here is crucial for processing your request.
4. In Section (1), indicate whether your condition qualifies under FMLA categories by checking the appropriate boxes. This helps clarify your eligibility for leave.
5. Provide detailed medical facts supporting your certification in Section (2). Be specific about how your condition meets FMLA criteria.
6. Complete Sections (3) and (4) regarding treatment details and expected recovery times. This information is vital for understanding your absence duration.
7. Finally, have your physician or practitioner fill out their section, including their signature and contact information, before submitting it back to the agency.

Start using our platform today to easily complete and submit your Connecticut Medical Certificate online for free!