View ESA-WHD's Form 1215-0181 Online
Agency: |
ESA-WHD |
Title: |
Family and Medical Leave Act of 1993 (Certification of Health Care Provider) |
Form Description: |
The Certification of Health Care Provider is an optional form that an employer may use if it chooses to require certification from a health care provider that a serious health condition requiring leave under the Family and Medical Leave Act (FMLA) exists. |
OMB Control Number: |
1215-0181 |
OMB Expiration Date: |
Thursday, September 30, 2010
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