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The Family and Medical Leave Act

The Family and Medical Leave Act (FMLA) of 1993 is a federal law which helps employees balance their work responsibilities with their family and medical needs. The Act sets national standards for employers when providing leave for such purposes. The Act requires that eligible employees be allowed to take unpaid leave, or paid leave if earned, for a period of up to 12 workweeks in a 12-month period in the event of the birth of a child or the placement of a child for adoption or foster care; because the employee is needed to care for an immediate family member (spouse, child or parent) with a serious health condition; or because an employee's own serious health condition makes them unable to do their job.

FMLA Forms:

Please contact the Human Resource office at 2253 or 4126 to obtain the following forms for FMLA:

  • Application for Family and Medical Leave
  • Certification of Health Care Provider (U.S. Department of Labor)
  • Family Medical Leave Act Brochure
  • Supervisor's Guide to Administering FMLA (Supervisor's Use)
  • Form A (Supervisor's Use)
  • Employee Rights and Responsibilities (42kB)‌

For more information about your FMLA rights and responsibilities, please contact LaDonna Young by e-mail at or by phone at 964.2253 or Jennifer Neitzel by e-mail at or by phone at 964.4126.