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FMLA TOOLKIT
City of Milwaukee, Department of Employee Relations

City of Milwaukee FMLA Policy


FMLA Forms for General City Departments

  1. FMLA Notice of Eligibity and Notice of Employee Rights & Responsibilities (r. 03.31.17)
  2. FMLA Request for Family and Medical Leave (r. 08.17.17):  Word  /  PDF
  3. FMLA Designation Notice (r. 09.20.17)
  4. Certification of Health Care Provider for Employee's Serious Health Condition (Family and Medical Leave Act) U.S. Department of Labor; Form WH-380-E (r. 05.15)
  5. Certification of Health Care Provider for Family Member's Serious Health Condition (Family and Medical Leave Act) U.S. Department of Labor; Form WH-380-F (r. 05.15) 
  6. Certification of Serious Injury or Illness of Covered Servicemember for Military Family Leave (Family and Medical Leave Act) U.S. Department of Labor; Form-385 (r. 02.13) 
  7. Certification of Qualifying Exigency for Military Family Leave (Family and Medical Leave Act) U.S. Department of Labor; Form-384 (r. 02.13) 

Other Information


Required Postings


FMLA Questions?  Send e-mail to vrober@milwaukee.gov.

r. 08.17.17