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Original Author: Grubbs, John
Date of Material: 06/05/2015

Subjects(s):
Family and Medical Leave Act of 1993
Personnel--Forms

FMLA Forms

Reviewed Date: 07/29/2021
Summary:
Links to FMLA forms are provided here.


Here are the links to the latest FMLA forms provided by the Department of Labor -- Wage and Hour Division: (Links updated July 2021)

Form WH-380-E - Certification of Health Care Provider for Employee’s Serious Health Condition (PDF) (Revised June 2020)
https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-380-E.pdf

WH-380-F - Certification of Health Care Provider for Family Member’s Serious Health Condition (PDF) (Revised June 2020)
https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-380-F.pdf

WH-381 - Notice of Eligibility and Rights & Responsibilities (PDF)  (Revised June 2020)
https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-381.pdf

WH-382 - Designation Notice Under the Family and Medical Leave Act (PDF) (Revised June 2020)
https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-382.pdf

WH-384 - Certification For Military Family Leave fro Qualifying Exigency Under the Family and Medical Leave Act (PDF) (Revised June 2020)
https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-384.pdf

WH-385 - Certification for Serious Injury or Illness of Covered Servicemember for Military Caregiver Leave Under the Family and Medical Leave Act (PDF) (Revised June 2020)
https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/WH-385.pdf

WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave Under the Family and Medical Leave Act (PDF) (Revised June 2020) 
https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/wh-385-V.pdf



Check this site for more information: https://www.dol.gov/agencies/whd/fmla/forms

Reference Document(s)
file FMLA Forms Now Updated by DOL.docx
Attachments:
file FMLA Forms Now Updated by DOL.pdf