DOL Releases New Model FMLA Forms
The Department of Labor has released new FMLA Model Forms for employers to use (optionally) to administer FMLA leaves. These updated templates have been approved through 2/28/15. The prior forms expired in December of 2011. Please note there have been no changes on these forms.
- Form WH-380-E – Certification of Health Care Provider for Employee’s Serious Health Condition
- WH-380-F – Certification of Health Care Provider for Family Member’s Serious Health Condition
- WH-381 – Notice of Eligibility and Rights & Responsibilities
- WH-382 – Designation Notice
- WH-384 – Certification of Qualifying Exigency For Military Family Leave
- WH-385 – Certification for Serious Injury or Illness of Covered Service member — for Military Family Leave
To access these updated versions, please go to http://www.dol.gov/compliance/laws/comp-fmla.htm#etools.
If you have any questions about the FMLA Model forms, please contact your Client Executive at WGA or direct compliance questions to firstname.lastname@example.org.