Family and Medical Leave Request Forms
Employees
Form
UCPEA
Employee Request
Intent to Return to Work
Medical Certificate (Personal Illness/Injury, Maternity)
Medical Certificate (Family Illness/Injury)
Application to Sick Leave Bank Committee
AAUP
Employee Request
Intent to Return to Work
Request for Paid Medical Leave
Medical Certificate (Personal Illness/Injury, Maternity)
Medical Certificate (Family Illness/Injury)
NP-2, NP-3, NP-5, P-2
Employee Request
Intent to Return to Work
Medical Certificate (Personal Illness/Injury, Maternity)
Medical Certificate (Family Illness/Injury)
Managerial/Confidential
Employee Request
Intent to Return to Work
Medical Certificate (Personal Illness/Injury, Maternity)
Medical Certificate (Family Illness/Injury)
Law School Faculty
Employee Request
Intent to Return to Work
Medical Certificate (Personal Illness/Injury, Maternity)
Medical Certificate (Family Illness/Injury)
