Family Medical Leave (FML)
Related Information
Family and Medical Leave is a benefit that provides eligible employees up to 12 weeks of unpaid leave in a 12 month period for:
- the birth and care of the newborn child of the employee;
- for placement with the employee of a son or daughter for adoption or foster care;
- to care for an immediate family member (spouse, child, or parent) with a serious health condition; or
- to take medical leave when the employee is unable to work because of a serious health condition
How to Apply for Family Medical Leave
You must complete the Request for Family or Medical Leave form 
and include your supervisor’s signature. Your department keeps the original; you keep a copy and send a copy to HRM. Please have your physician complete the Certification of Health Care Provider Form. The physician’s office can fax the completed form to Human Resources Management (HRM), 972-883-2156, attention Vivian Rutledge. HRM reviews your form and documentation and issues you and your department an Employer Response to Employee regarding your eligibility.
Forms Required
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Last Updated: February 8, 2008
