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Medical Certification

The FMLA/CFRA Medical Certification Form must certify that the absence is required for a ‘serious health condition’ of the employee or the employee’s family member.

It must include:

  • Start date of the condition
  • The expected duration of absence
  • The anticipated return to work date
  • Signature of the health care provider

The certification must not include diagnosis, but must detail the required time away from work. The medical certification is private and confidential and should be submitted directly to Human Resources Department, within 15 days of your request for leave.

Intermittent leave may be taken as the condition requires. However, the treating practitioner must provide specific information regarding frequency and duration of intermittent leave. If leave is for medical appointments, specific dates and times must be provided by the healthcare practitioner.

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