Request for Leave
The University chooses to provide very liberal leave policies under the Family Medical Leave Act (FMLA) and for Maternity, Adoption and Parental Leave (Paternal Leave). Information on the FMLA policy and the can be found in the Employee Handbook.
To facilitate a leave under one of these policies:
1. Complete this form and hit submit (will forward to Human Resources)
2. Provide Documentation
Leave due to Medical needs: FOR YOURSELF, ask a physician to fill out and return it to the Human Resources office.
Leave due to Medical needs of YOUR SPOUSE, DEPENDENT, PARENT: Ask a physician to fill out and return it to the Human Resources office.
MILITARY: Special federal forms are used to cover leaves related to military service members. For injured family member, please use . For an exigency, please use .
ADOPTION, JURY DUTY OR DEATH OF A FAMILY MEMBER: Provide documentation/certification