Family and Medical Leave Request Form

FMLA Form Update
October 2009

Family and Medical Leave Request Form

What's Changed?
On October 29th, 2009 President Obama signed into law National Defense Authorization Act for Fiscal Year 2010 which amended the FMLA. The updated Family Medical Leave Request Form contains updated information pertaining to the new leave entitlements.

This form provides a standardized, clear method for employees to request FMLA leave from their employers. It also informs employees of their rights under FMLA, as is required by law.

Each pack contains 50 request forms.

Preview FMLA Form Here

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