Employee Complete The Employee Information Section Sign https://abilityadvantage.thehartford.com/documents/24_CA_Medical_Cert___Employee_Serious_Health_Condition.pdf You will need to return this form to The Hartford no later than 15 days from the date you requested leave. Forms can be mailed to: The Hartford P.O. Box 14869 Lexington, KY 40512-4869 OR faxed to . Toll Free Fax Number: 833-357-5153. Section I: For Completion by the EMPLOYEE Employee’s Full Name: Last 4 digits of Social Security Number: Leave ID: Date of Birth: Employer Name: … Global Rank: 943 Pageviews: 42 M Top Country: US Site Status: Up Employers Absence Management Administration The Hartford https://www.thehartford.com/employee-benefits/employers/absence-management/administration 3 The Hartford’s ADA Workplace … Continue reading FMLA Form Hartford