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FMLA Sample letters & Checklist

Adobe Acrobat PDF Format

Microsoft Word Document Format

Family Medical Leave Act CHECK LIST

Family Medical Leave Act CHECK LIST

Sample 1: Leave Time Designated as FMLA

Sample 1: Leave Time Designated as FMLA

Sample 2: Provisional approval letter for potential serious health condition of the employee

Sample 2: Provisional approval letter for potential serious health condition of the employee

Sample 3: Provisional approval letter for potential serious health condition of the employee

Sample 3: Provisional approval letter for potential serious health condition of the employee

Sample 4: Denial-Medical

Sample 4: Denial-Medical

Sample 5: Denial-Time Worked

Sample 5: Denial-Time Worked

Sample 6: Denial-Not a Qualified Relationship

Sample 6: Denial-Not a Qualified Relationship

Sample 7: Warning of Leave Expiration

Sample 7: Warning of Leave Expiration

Sample 8: Warning of Exceeded Leave

Sample 8: Warning of Exceeded Leave

Sample 9: Approval + Reason/Type of Leave

Sample 9: Approval + Reason/Type of Leave

FMLA Usage Report

 

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