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Forms and templates

Forms

Forms

Forms to be completed by employee and certified by healthcare provider(HCP)
Family member’s serious health condition
Fitness for duty certification
Maternity-related disability
Military family leave – serious injury or illness of service member
Military caregiver leave – serious injury or illness of a veteran
Parental leave for parent other than birth mother
Personal serious health condition

Forms to be completed by employee (verification documents required; HCP certification not required)
Domestic violence-related leave
Military family leave – qualifying exigency
Leave without pay 

Note: To request a leave without pay for personal reasons or a military duty leave under USERRA, contact your local unit administrator.

Templates