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Procedures for implementing Family and Medical Leave vary from one UC location to another. Following are samples compiled from throughout the UC system. Check with your Human Resources or Academic Affairs office or website for local forms and procedures

Filename Description
word doc icon acad_fml_chklst Checklist for Academic Employees
word doc icon acad_leave_frm Academic Leave Form
word doc icon fml_chklst FML Checklist (Staff)
word doc icon fml_dec_rel Declaration of Relationship
word doc icon fml_med_cert Medical Certificate
word doc icon reduce (Exempt Employees) Record of Reduced Work/Intermittent Leave Schedule
word doc icon request Leave of Absence Request
word doc icon rights FMLA Rights and Obligations
word doc icon rtw_cert Return to Work Certification