FMLA Form Kansas

The FMLA allows employees to balance their work and family life by taking reasonable paid or unpaid leave for certain family and medical reasons. Applies to: Eligible employees include any employee who: have been employed by the State of Kansas/University in a position for at least 12 months within the last seven years (does not have to be consecutive); and; have worked for …

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The Family and Medical Leave Act (FMLA) is a federal law that provides eligible employees entitlement to up to 12 work weeks of paid or unpaid leave during a consecutive 12 month period for the birth of the employee’s child, the placement with the employee of a child for adoption or foster care, a qualifying serious health condition of the employee, or a serious health condition …

After the completed Request for Family/Medical Leave under the FMLAform has been received and reviewed, complete the Notice of Eligibility and Rights & Responsibilities (Family and Medical Leave Act)WH-381 form and the Designation Notice (Family and Medical Leave Act)WH-382 form, and give to the employee via hand delivery or certified mail.

After completing the necessary form, the employee should return the form and any required documentation within 15 calendar days of the employee’s first day of absence by email to [email protected] or by fax to 785-864-5790. Failure to return a completed form in the timeframe provided may cause delay or denial of FMLA coverage.

: Certification form to be completed by you and an authorized healthcare provider to support a request for FMLA leave due to a serious injury or illness of a covered service member. After completing the necessary form, you should return it and any required documentation within 15 calendar days of your first day of absence by email to [email protected]