Family & Medical Leave Act (FMLA)

Any employee (including part-time and temporary) of the University of Georgia, who has...

• been employed by the University of Georgia for at least twelve months total (not necessarily the last twelve months),

  and

• worked at least 1,250 hours during the 12-month period immediately preceding the leave

...is eligible to be granted family leave for conditions authorized by the Family and Medical Leave Act.
The Act provides that employees may be granted up to twelve work weeks of job-protected leave during a 12-month period, or 26 work weeks in the case of qualifying exigencies related to certain military-related situations.

• What circumstances qualify me to take family leave?
• How FMLA works: General guidelines
• What are the military notification requirements under the FMLA?
• The responsibilities of the employee regarding FMLA
• The responsibilities of the supervisor regarding FMLA
• How FMLA may affect my accumulated leave time
• How FMLA may affect my health insurance premiums
• FMLA Terms and Definitions

Forms related to FMLA

• Family & Medical Leave Request (PDF)
• Institutional Response to Employee Request for Family Leave (PDF)
• WH-380-E - Certification of Health Care Provider for Employee's Serious Health Condition (PDF)
• WH-380-F - Certification of Health Care Provider for Family Member's Serious Health Condition (PDF)
• WH-381 - Notice of Eligibility and Rights & Responsibilities (optional) (PDF)
• WH-382 - Designation Notice (optional) (PDF)
• WH-384 - Certification of Qualifying Exigency For Military Family Leave (PDF)
• WH-385 - Certification for Serious Injury or Illness of Covered Servicemember -- for Military Family Leave (PDF)
• Medical Evaluation (Return to Work) (PDF)

Other related forms

• UGA leave request
• UGA leave without pay

Revised 07/8/09