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›SampleFormforLongTerm-TerminalIllnessThisformmustbecompletedbyaHealthCareProviderwhenFMLAleaveisrequestedandmedical documentationisrequiredpursuantto,andofELM.Inallinstancestheinformationontheformmustrelateonlytotheserioushealthconditionfor›SampleForm forHospitalStayFMLACertificationofHealthCareProviderforFamilyMember’sSeriousHealthCondition,,WHFMLANoticeofEligibilityandRightsand FMLAFormMedicalCertification Employee’sOwnSeriousHealthCondition(NALC,Revised5/24/13)FMLAFormMedicalCertification Family Member’sSeriousTheFamilyandMedicalLeaveAct(FMLA)isafederallawthatprovideseligibleemployeeswithjob-protectedleaveforqualifyingfamilyand medicalreasons›SampleFormforChronicCondition›SampleFormforMultipleTreatments›SampleFormforPregnancyCERTIFICATIONOF EMPLOYEE'SSERIOUSHEALTHCONDITIONFORFAMILYANDMEDICALLEAVE›SampleFormforChildwithChronicConditionIftheleave qualifiesforboth,theUSPScannotcountitagainstboththeweekmilitaryFormPSalsomustbecompletedbyemployeeandsubmittedtoproperlyrequest FMLAleave.APWUForm1isforleaveforanemployee’sownserioushealthconditionandAPWUForm2isforleavetocareforafamilymember’sserious healthconditionIngeneral,tobeeligibletotakeleaveundertheFamilyandMedicalLeaveAct(FMLA),anemployeemusthaveworkedforanemployerforat leastmonths,meetthehoursofservicerequirementinthemonthsprecedingtheleave,andworkatasitewithatleastemployeeswithinmilesTheFamilyandMedical LeaveAct(FMLA)providescertainemployeeswithuptoweeksofunpaid,job-protectedleaveperyearThefollowingdefinitionsapplyforthepurposesof AbsenceforFamilyCareorIllnessofEmployee:Subparts(a)through(c)applytoleaveforone’sownoraTheaddressfortheHRSSCtowhichtheemployee mustsubmittheFMLAform(s)canbefoundontheareamapsincludedintheNALCFMLAformsPDFChangestoFMLAAPWUFMLAFormComplete OnlineVersion[PDF]CertificationbyaHealthCareProviderforaFamilyMember’sseriousIllness:APWUFMLAFormCompleteOnlineVersion[PDF] CertificationbyEmployeeofQualifyingExigencyforMilitaryFamilyLeave:APWUFMLAFormCompleteOnlineVersion[PDF]FMLANoticeofEligibilityand RightsandResponsibilities,WHFMLACertificationforQualifyingExigencyforMilitaryFamilyLeave,WHFMLACertificationforSeriousInjuryorIllnessof CoveredServicemember forMilitaryFamilyLeave,TheaddressfortheHRSSCtowhichtheemployeemustsubmittheFMLAform(s)canbefoundonthe areamapsincludedintheNALCFMLAformsPDFChangestoFMLARegulations:DOLExpandsMilitaryFMLALeaveTheAPWUhasupdatedourFMLA formsandcreatedtwonewFMLAformsforemployeesinmilitaryfamilies›SampleFormforEmployee’sAbsencePlusTreatmentTheUSDepartmentleave andFMLAleave,theUSPSmustdesignateitasmilitarycaregiverleavefirstItalsorequiresthattheirgrouphealthbenefitsbemaintainedduringtheleaveSample FMLAForms.PLEASEREVIEWTHEFORMAND.&OMPLETEALLSECTIONSTHATHandbooks,Forms,andManuals.GrievanceStatementformto turnintostewardpdf;CollectiveBargainingAgreement–pdf;–CollectiveBargainingDefinitionsPleasenotethattheAPWUformshavealsobeenrenumbered