Medical Certification for FMLA/CFRA-removed

An employee can request time off for any reason covered by the FMLA/CFRA either verbally or in writing. If an employee wishes time off under the FMLA/CFRA, this is one of the forms that should be completed. Timely completion of these forms will help ensure that approval of leave is not delayed, and that benefits, pay status during leave, and disability insurance application are processed as requested.