Department of Labor releases New FMLA Forms

Forms: Final Rule to Implement Statutory Amendments to the Family and Medical Leave Act

The U.S. Department of Labor (DOL) has issued new forms for employers to use in connection with employee leave under the Family and Medical Leave Act (FMLA). The new forms, which replace the forms that expired in February, are essentially unchanged, with one notable exception. The new forms now directly reference the Genetic Information Nondiscrimination Act (GINA), which prohibits employers from requesting or requiring disclosure of genetic information of an employee or family member of an employee, except under certain circumstances.

• 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 (PDF)
• WH-382 Designation Notice (PDF)
• WH-384 Certification of Qualifying Exigency For Military Family Leave (PDF)
• WH-385 Certification for Serious Injury or Illness of Current Servicemember -- for Military Family Leave (PDF)
• WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (PDF)