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- Family Medical Leave
Family Medical Leave
Information
- Employee's Guide to The Family and Medical Leave Act
- Military / Family Leaves - Summary of family leave for military spouses and caregivers
- United States Wage and Hour Division FMLA Poster
Forms
To apply for medical leave, please complete the leave-of-absence application form and applicable certification form listed below.
Submit the application to your department's designated HR Partner.
Provide the supporting certification to HR FAX# (253)798-8558 or scan and email it to the HR Absence Partner at HR@co.pierce.wa.us .
| If Family Leave is for... |
Complete the Leave Request Application (link above) and the applicable form below: |
|---|---|
| Employee's own health condition |
Certification of health care provider for employee's serious health condition |
| Family member's health condition | Certification of health care provider for family member's serious health condition |
| Injury / illness of covered military service member |
Certification for serious injury or illness of covered service member for military family leave |
| Qualifying exigency for active-duty military family member |
Certification of qualifying exigency for military family leave |
| Injury / illness of military veteran | Certification for serious injury or illness of a Veteran for Military Caregiver leave |