Family and Medical Leave

1. An applicant for Family and Medical Leave (FML) initiates the request by completing the Family and Medical Leave (FML) Request Forms Part I and Part II and attaches:
   • a letter from the Department Chair detailing the duties you will be assigned upon your return from leave.
   • a form from the Benefits Office stipulating the arrangements for health and retirement benefits.
   • if appropriate, legal documentation of adoption or foster care of a child.
   • if appropriate, medical documentation that includes a statement of medical facts meeting the criteria for serious medical conditions as defined by the Policy on Family and Medical Leave, including:
   • the date the condition commenced;
   • the regiment of treatment to be prescribed;
   • the estimated duration of absence from work;
   • in the case of the faculty member's serious health condition, certification that the faculty member is unable to perform the essential functions of his/her position;
   • in the case of the faculty member's need to care for a seriously ill family member, certification of the necessity for and duration of the faculty member's presence;
   • the title and original signature of an accredited, licensed or certified medical provider.
2. When the need for Family and Medical Leave is foreseeable, the application should be made at least thirty (30) calendar days before the leave is to begin. When the need is not foreseeable, the application should be made as soon as practicable.
3. These materials should be submitted through the Department Chair to the Dean.
4. The Dean must sign the form and forward it to the Associate Provost for Faculty Affairs, 1119 Main Administration Building, for review and approval.
5. Once approved, copies of FML Parts I and II and the Benefits Office form are forwarded to the faculty member, Department Chair, Dean, Benefits Office and Data Services Office. The original material will be kept in the Office of the Provost.