403.7-E5 - FMLA Certification of Health Care Provider for Family Member's Serious Health Condition

Click here to download the FMLA Certification of Health Care Provider for FAMILY MEMBER'S Serious Health Condition form


Reviewed: 9/14; 3/17; 4/20
Related Policy: 403.7; 403.7-R1-R2; 403.7-E1-E4, E6-E9