FMLA (Family Medical Leave Act)

The FMLA (Family Medical Leave Act) entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the terms and conditions as if the employer had not taken leave.

FMLA applies to all public agencies, including state, local and federal employers, local education agencies (schools), and private employers who employee 50 or more employees in 20 or more workweeks in the current or proceeding calendar year, including joint employers and successors of covered employers.

Employee Eligibility

  • To be eligible for FMLA benefits, an employee must:
  • Work for a covered employer
  • Have worked for the employer for a total of 12 months
  • Have worked at least 1,250 hours over the previous 12 months; and
  • Work at a location in the United States or in any territory or possession of the United States where at least 50 employees are employed by the employer within 75 miles


FMLA Request Form

Medical Certification Form, Employee

Medical Certification Form, Employee’s Family Member