Model language for awfully requesting medical information-Title II of the Genetic Information Nondiscrimination Act (GINA) prohibits covered employers from requesting or requiring genetic information of an individual or family member. When requesting medical information from employees or applicants, such as for medical examination purposes or in connection with requests for medical leave, employers should use this model language on all applicable forms.
Return to work Medical Certification-This Return to Work Authorization should be completed by the employee’s health care provider when returning from leave due to an illness or injury.
Leave of Absence Request-A form for employees to fill out when requesting a leave of absence
Qualifying Exigency Certification-This form is to be completed by an employee requesting FMLA due a to family member in the armed services experiencing a qualifying exigency.
Designation Notice-This form is used to designate leave as FMLA-qualifying. It must be provided to the employee within 5 business days from the time the employer has enough information to determine whether the requested leave is for a FMLA-qualifying reason.
Certification for Serious Injury – This document is to be completed by the employee’s physician and serves as a medical certification demonstrating an employee’s need to take FMLA leave due to a serious health condition.