FMLA Leave Request

Request for FMLA (Family Medical Leave Act) Leave should be submitted no less than 30 days prior to the need for leave for a known medical condition or as soon as practicable if unknown.  The form should be completed for your own or a covered family members serious health condition and faxed to (313) 748-6119.   Leaves cannot be approved until a complete and sufficient Certification of Health Care Provider form has been received and reviewed.

FMLA Request --12-2019.pdf, 184.38 KB; (Last Modified on December 10, 2019)