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Family Medical Leave Act (FMLA)

FMLA at Kootenai Health The Family Medical Leave Act of 1993 provides up to 12 weeks of job protected leave to eligible employees for certain family and medical reasons. You are eligible for FMLA if you have worked for Kootenai Health for at least one year and worked for 1,250 hours over the previous 12 months.

Some common reasons for taking FMLA: • To care for your child after birth or adoption • To care for a spouse, child or parent with a serious health condition • For a serious health condition that makes you unable to perform your job

Call 877.462.3652 or visit: for more information or to apply for FMLA

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FMLA Checklist q Contact FMLASource Website: Phone: 877.462.3652 Fax: 877.309.0218 Email: q Receive a medical certification form from FMLASource or download it from their website q Take the medical certification form to the physician for completion q Verify that the physician completed the medical certification form q Verify that FMLASource received the completed medical certification form directly from the physician office q Wait to receive an FMLA decision letter from FMLASource q If approved for leave: Intermittently - Contact your manager and FMLASource prior to each absence Continuously - Contact your manager and FMLASource to report your return to work date q If denied for leave, contact FMLASource For more information review the Kootenai Health FMLA policy or contact FMLASource at 877.462.3652 Human Resources 2003 Kootenai Health Way Coeur d’Alene, Idaho 83814 208.666.2050 tel

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Family Medical Leave Act