Guidance on Family Medical Leave Policy for Residents


Overview

Policy

Sick and Vaction Leave

Medical Insurance

  • Medical Foundation continues to contribute its share of premium sharing for insurance at the department's expense
  • Notice/Certification

  • 30 days or as soon as practical
  • Verbal notice is sufficient
  • Department may require certification from the health care provider

  • Commonly Asked Questions About FMLA


    FMLA Forms


    Request for Family or Medical Leave - to be completed by employee and returned to residency coordinator.

    Certification of Health Care Provider - Resident/Fellow
    -to be completed by health care provider & resident and returned to coordinator.

    Certification of Health Care Provider - Family Member - to be completed by health care provider & resident and returned to coordinator.

    Certification of Health Care Provider - Family Member with Military Injury - to be completed by health care provider & resident and returned.

    Certification of Qualifying Urgency for Military Family Medical Leave- to be completed by the resident and returned with the above form.

    Acknowledgement & Approval Form for Family Medical Leave - Completed by Program Director within 5 days of request submission.

    Certification of Fitness for Duty - to be completed by health care provider and returned

    Time Log- to be maintained by residency program timekeeper.

    FMLA Sample Letters

    (Downloadble Word Documents - may be edited to fit specific situations.)

    FMLA Certification Request Letter-  Letter from supervisor to employee requesting completion of the Certification of Health Care Provider Form.

    FMLA First Letter for Illness -  Letter from supervisor to employee regarding FMLA.

    FMLA First Letter (Baby)
    - Letter from supervisor to employee regarding FMLA available for pregnancy leave.

    FMLA Middle Letter -Follow-up FMLA letter from supervisor to employee.

    FMLA Extension Letter -Letter from supervisor to employee regarding FLMA expiration and options available if additional time is needed.


    Human Resources Advising Team


    Emil Dela Cruz - Insurance & Benifits Questions - 713-500-5247
    April A. Bass - Leave of Absence Paperwork - 713-500-5154