Family and Medical Leave and Parental Leave
Download and submit the appropriate medical certification that applies to your situation.
Do not open the PDFs in the browser.
| Medical Certification Forms for Employee or Family Member | Medical Certification Forms for Serious Injury/Illness of Covered Service Member | Medical Certification Forms for Qualifying Exigency for Military Family Leave |
|---|---|---|
| Certification of Health Care Provider for Employee (PDF) | Caregiver Certification for Serious Injury/Illness of Covered Service Member (PDF) | Certification of Qualifying Exigency for Military Family Leave (PDF) |
| Certification of Health Care Provider for Family Member (PDF) | Certification for Serious Injury/Illness of Covered Service Member (PDF) | |
| Certification for Serious Injury/Illness of a Veteran for Military Caregiver leave |
Family and Medical Leave Application
Please read the policies for more information or if you are unsure which leave is applicable to you.
Leave Policy Links
UHD Family and Medical Leave Policy
FML Forms and Information
FMLA Authorization for the Release of Medical Information (PDF)